Provider Demographics
NPI:1609940543
Name:KINSEY, KATHRYN L (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:L
Last Name:KINSEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 E H ST
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-3345
Mailing Address - Country:US
Mailing Address - Phone:707-747-1390
Mailing Address - Fax:707-745-1587
Practice Address - Street 1:281 E H ST
Practice Address - Street 2:
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-3345
Practice Address - Country:US
Practice Address - Phone:707-747-1390
Practice Address - Fax:707-745-1587
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS61231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical