Provider Demographics
NPI:1932561842
Name:BLINSKY, KAITLIN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KAITLIN
Middle Name:
Last Name:BLINSKY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:
Other - Last Name:WEIGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2718 GATEWAY AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0585
Mailing Address - Country:US
Mailing Address - Phone:701-498-2474
Mailing Address - Fax:701-540-5763
Practice Address - Street 1:2718 GATEWAY AVE STE 104
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0585
Practice Address - Country:US
Practice Address - Phone:701-498-2474
Practice Address - Fax:701-540-5763
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND5690104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty