Provider Demographics
NPI:1427327899
Name:SLETTE, KIMBERLY KAY (LICSW)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KAY
Last Name:SLETTE
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 1:151 SAINT ANDREWS CT STE 710
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-8815
Mailing Address - Country:US
Mailing Address - Phone:507-386-7121
Mailing Address - Fax:507-344-0690
Practice Address - Street 1:151 SAINT ANDREWS CT STE 710
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-8815
Practice Address - Country:US
Practice Address - Phone:507-386-7121
Practice Address - Fax:507-344-0690
Is Sole Proprietor?:No
Enumeration Date:2011-12-14
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical