Provider Demographics
NPI:1639588437
Name:KINKEL, KAY A (LICSW)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:A
Last Name:KINKEL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3713
Mailing Address - Country:US
Mailing Address - Phone:612-879-5320
Mailing Address - Fax:612-879-5282
Practice Address - Street 1:800 WACONIA PKWY N
Practice Address - Street 2:
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-9241
Practice Address - Country:US
Practice Address - Phone:612-879-5320
Practice Address - Fax:612-879-5282
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN237221041C0700X
IA0721551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical