Provider Demographics
NPI:1629720818
Name:KINSHIP LLC
Entity Type:Organization
Organization Name:KINSHIP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC CO-OWNER AND DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:IANTAFFI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:612-483-5726
Mailing Address - Street 1:2332 WHITTIER ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55803-1426
Mailing Address - Country:US
Mailing Address - Phone:612-483-5726
Mailing Address - Fax:
Practice Address - Street 1:2332 WHITTIER ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55803-1426
Practice Address - Country:US
Practice Address - Phone:612-483-5726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty