Healthcare Provider Details

I. General information

NPI: 1871309955
Provider Name (Legal Business Name): SARAH NICOLE RIMA LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10900 89TH AVE N STE 3
MAPLE GROVE MN
55369-4025
US

IV. Provider business mailing address

3460 WASHINGTON DR STE 109
EAGAN MN
55122-4301
US

V. Phone/Fax

Practice location:
  • Phone: 651-560-0050
  • Fax: 651-925-0257
Mailing address:
  • Phone: 651-560-0050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4721
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: