Provider Demographics
NPI:1093598443
Name:KOBINSKY, KRISTEN MARY (MS)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MARY
Last Name:KOBINSKY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:MARY
Other - Last Name:HOMSTAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:2399 ARIEL ST N STE D
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-2202
Mailing Address - Country:US
Mailing Address - Phone:651-770-1311
Mailing Address - Fax:651-770-1789
Practice Address - Street 1:2399 ARIEL ST N STE D
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-2202
Practice Address - Country:US
Practice Address - Phone:651-770-1311
Practice Address - Fax:651-770-1789
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health