Provider Demographics
NPI:1992364350
Name:BINSFIELD, KODI KAI
Entity Type:Individual
Prefix:
First Name:KODI
Middle Name:KAI
Last Name:BINSFIELD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 INDIAN TRAIL BLVD
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-3651
Mailing Address - Country:US
Mailing Address - Phone:231-492-6191
Mailing Address - Fax:
Practice Address - Street 1:8300 E YALE AVE APT 2-305
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-3847
Practice Address - Country:US
Practice Address - Phone:231-492-6191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-10
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst