Healthcare Provider Details

I. General information

NPI: 1457455891
Provider Name (Legal Business Name): SARAH ELIZABETH HEUSER LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH ELIZABETH WHITE

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VETERANS DR MAIL STOP 116A-2/3
MINNEAPOLIS MN
55417-2309
US

IV. Provider business mailing address

1 VETERANS DR MAIL STOP 116A-2/3
MINNEAPOLIS MN
55417-2309
US

V. Phone/Fax

Practice location:
  • Phone: 612-725-2000
  • Fax: 612-725-2139
Mailing address:
  • Phone: 612-725-2000
  • Fax: 612-725-2139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number17968
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: