Healthcare Provider Details

I. General information

NPI: 1558833137
Provider Name (Legal Business Name): SARAH PRISCILLA OPITZ BA, LSW, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2018
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 8TH ST S STE 3
MOORHEAD MN
56560-3658
US

IV. Provider business mailing address

200 5TH ST S STE 105
MOORHEAD MN
56560-2768
US

V. Phone/Fax

Practice location:
  • Phone: 218-284-1800
  • Fax: 218-284-1801
Mailing address:
  • Phone: 218-284-1800
  • Fax: 218-284-1801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number26974
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number305693
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: