Jacqueline Therese Kobliska

Individual provider Active NPI Clinical Social Worker · Staples, MN

NPI 1922711399 · NPPES record last updated Mar 25, 2026

Key facts

NPI
1922711399
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
77486 (MN)
Practice address
121 4TH St NE
Staples, MN 56479-2545
Phone
(320) 905-4345
Fax
(507) 218-8492
NPI assigned
Jan 2, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 77486 MN Yes

Addresses

Primary practice location

121 4TH St NE
Staples, MN 56479-2545

Mailing address

121 4TH St NE
Staples, MN 56479-2545
Phone (320) 905-4345

Other providers in Staples, MN

All providers in Staples, MN · Clinical Social Worker in Minnesota

Sources for this page

Verify at the official NPI Registry.