Provider Demographics
NPI:1275117780
Name:AHLES, KAYLA (LPCC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:AHLES
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 MCCARRONS BLVD N APT 107
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-6976
Mailing Address - Country:US
Mailing Address - Phone:715-210-0664
Mailing Address - Fax:
Practice Address - Street 1:3000 AMES CROSSING RD STE 600
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-2519
Practice Address - Country:US
Practice Address - Phone:651-774-0011
Practice Address - Fax:952-431-2211
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2576101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional