Healthcare Provider Details

I. General information

NPI: 1700816279
Provider Name (Legal Business Name): SARAH BARRETT LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 08/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11900 WAYZATA BLVD STE 112
MINNETONKA MN
55305-2018
US

IV. Provider business mailing address

754 UPPER COLONIAL DR
MENDOTA HEIGHTS MN
55118-2715
US

V. Phone/Fax

Practice location:
  • Phone: 651-252-4011
  • Fax: 844-965-9237
Mailing address:
  • Phone: 651-252-4011
  • Fax: 844-965-9237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18413
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: