Provider Demographics
NPI:1417935669
Name:ULBEE, MAUREEN ALICIA (MS, MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:ALICIA
Last Name:ULBEE
Suffix:
Gender:F
Credentials:MS, MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2356 UNIVERSITY AVE W STE 220
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1850
Mailing Address - Country:US
Mailing Address - Phone:651-209-2767
Mailing Address - Fax:651-209-2768
Practice Address - Street 1:2356 UNIVERSITY AVE W STE 220
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1850
Practice Address - Country:US
Practice Address - Phone:651-209-2767
Practice Address - Fax:651-209-2768
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN122381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN800001294Medicare ID - Type Unspecified