Healthcare Provider Details

I. General information

NPI: 1982822276
Provider Name (Legal Business Name): SARAH LYNNE STIGEN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 03/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 25TH AVE N
FARGO ND
58102-1938
US

IV. Provider business mailing address

509 25TH AVE N
FARGO ND
58102-1938
US

V. Phone/Fax

Practice location:
  • Phone: 701-232-6224
  • Fax: 701-232-4687
Mailing address:
  • Phone: 701-232-6224
  • Fax: 701-232-4687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2009-024
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1268
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: