Healthcare Provider Details

I. General information

NPI: 1356271274
Provider Name (Legal Business Name): SARA LYNN FISCHER LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14435 WOODVILLE DR
WASECA MN
56093-5156
US

IV. Provider business mailing address

14435 WOODVILLE DR
WASECA MN
56093-5156
US

V. Phone/Fax

Practice location:
  • Phone: 612-275-6293
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number36110
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number36110
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: