Healthcare Provider Details

I. General information

NPI: 1265398119
Provider Name (Legal Business Name): SARA DAVIS MSW, LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARA STAPLES

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W SUPERIOR ST STE 200
DULUTH MN
55802-1939
US

IV. Provider business mailing address

3822 W 5TH ST
DULUTH MN
55807-1610
US

V. Phone/Fax

Practice location:
  • Phone: 218-606-1100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34708
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: