Katelyn Sarah Kubista, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

31140 Issued in MN

Practice address

10000 Hwy 55 Ste 200
Plymouth, MN 55441-6433

Phone

(586) 707-7085

NPI assigned

Jul 1, 2025

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Katelyn Sarah Padalino Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1751328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1023907276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "976 PACIFIC ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551066324",
            "telephone_number": "586-707-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 HWY 55 STE 200",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554416433",
            "telephone_number": "586-707-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBISTA",
        "first_name": "KATELYN",
        "middle_name": "SARAH",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "31140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "PADALINO",
            "middle_name": "SARAH",
            "credential": "MSW, LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caila Blake Kritzeck, MA, LPCC, ATR-P
• Kadie Josephine Kroll, MA, LADC
• Kelly B. Kromer, MD
• Diane K Krump, BCMT, CRT
• Benjamin Kruse
• Tessa Elizabeth Kuechenmeister
• Kristin K Kuehl, DPT
• Kelly V. Kuka, D.C.
• Sergey V Kulikov, MD
• Thomas Kulus

• Clinical Social Worker in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.