Provider Demographics
NPI:1437341310
Name:KINZELL, KERRI DELAYNE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:DELAYNE
Last Name:KINZELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 DAHL RD
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-2782
Mailing Address - Country:US
Mailing Address - Phone:605-642-2777
Mailing Address - Fax:
Practice Address - Street 1:623 DAHL RD
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-2782
Practice Address - Country:US
Practice Address - Phone:605-642-2777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLCSW-7251041C0700X
SD31291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical