Provider Demographics
NPI:1194411470
Name:ULSBY, KAYLA HANZSEK-BRILL (LICSW)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:HANZSEK-BRILL
Last Name:ULSBY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:ELIZABETH
Other - Last Name:HANZSEK-BRILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2277 HIGHWAY 36 W STE 160
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-3830
Mailing Address - Country:US
Mailing Address - Phone:763-575-8086
Mailing Address - Fax:
Practice Address - Street 1:2277 HIGHWAY 36 W STE 160
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-3830
Practice Address - Country:US
Practice Address - Phone:763-575-8086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN291031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical