Healthcare Provider Details

I. General information

NPI: 1245145721
Provider Name (Legal Business Name): KAYLA BRUMM LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3399 SHADOW RIDGE DR
LOVELAND OH
45140-1585
US

IV. Provider business mailing address

1112 GABBERT CIR
EAGAN MN
55123-1844
US

V. Phone/Fax

Practice location:
  • Phone: 513-486-6621
  • Fax:
Mailing address:
  • Phone: 803-646-9599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.2512209
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: