Healthcare Provider Details

I. General information

NPI: 1013473404
Provider Name (Legal Business Name): KAYLA MARIE HANNA MS, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLA MARIE MEYER MS, LPCC

II. Dates (important events)

Enumeration Date: 02/11/2019
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 NE 3RD ST # 200H
GRAND RAPIDS MN
55744-2869
US

IV. Provider business mailing address

104 NE 3RD ST # 200H
GRAND RAPIDS MN
55744-2869
US

V. Phone/Fax

Practice location:
  • Phone: 218-999-7081
  • Fax:
Mailing address:
  • Phone: 218-999-7081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC02038
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: