Provider Demographics
NPI:1720873987
Name:SAULSBERRY, TYLAIAH (LMSW)
Entity type:Individual
Prefix:
First Name:TYLAIAH
Middle Name:
Last Name:SAULSBERRY
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5125 NE 23RD AVE UNIT 3311
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:IA
Mailing Address - Zip Code:50327-7033
Mailing Address - Country:US
Mailing Address - Phone:515-339-6291
Mailing Address - Fax:
Practice Address - Street 1:4309 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50311-3423
Practice Address - Country:US
Practice Address - Phone:515-996-5935
Practice Address - Fax:515-414-7638
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1287571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical