Provider Demographics
NPI:1679566368
Name:TOBEY, KATHLEEN KAY (LP LMFT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:KAY
Last Name:TOBEY
Suffix:
Gender:F
Credentials:LP LMFT
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:KAY
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17 1/2 N LAKE AVE RM 201
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-2018
Mailing Address - Country:US
Mailing Address - Phone:218-740-4389
Mailing Address - Fax:218-740-4389
Practice Address - Street 1:17 1/2 N LAKE AVE RM 201
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-2018
Practice Address - Country:US
Practice Address - Phone:218-740-4389
Practice Address - Fax:218-740-4389
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN772106H00000X
MN1757103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12769Medicaid
MN148052900Medicaid
MN156L3TOOtherBCBS