MEDICARE: SARAH MINAS LCSW

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	101YM0800X	Mental Health Counselor	LCSW-20821	AZ
2	101YM0800X	Mental Health Counselor	LCSW70854	CA

General Provider Information

NPI Number	:	1376902973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MINAS LCSW

Provider Business Mailing Address
First Line	:	864 GRAND AVE # 107
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-3906
Country	:	US
Telephone Number	:	858-880-7121
Fax Number	:

Provider Business Practice Location Address
First Line	:	864 GRAND AVE # 107
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-3906
Country	:	US
Telephone Number	:	858-880-7121
Fax Number	:

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

Provider Enumeration Date	:	02/11/2016
Last Update Date	:	02/18/2026

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Directions to “ SARAH MINAS LCSW” Practice Location

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