MEDICARE: MS. MAUREEN ALICIA ULBEE MS, MSW, LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	12238	MN

General Provider Information

NPI Number	:	1417935669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MAUREEN ALICIA ULBEE MS, MSW, LICSW

Provider Business Mailing Address
First Line	:	2356 UNIVERSITY AVE W STE 220
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55114-1850
Country	:	US
Telephone Number	:	651-209-2767
Fax Number	:	651-209-2768

Provider Business Practice Location Address
First Line	:	2356 UNIVERSITY AVE W STE 220
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55114-1850
Country	:	US
Telephone Number	:	651-209-2767
Fax Number	:	651-209-2768

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	05/02/2021

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