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General NPI Number Information
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NPI Number | 1154508216
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Entity Type | Individual
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Provider Name | SARA A ERIE MS NCC LPCC
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Gender | Female
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Dates
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Enumeration Date | 01/30/2008
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 40520 COUNTY HIGHWAY 34 MENTAL HEALTH
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City | OGEMA
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State | MN
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Zip | 56569-9612
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Country | US
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Telephone | 218-983-6325
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Fax | 218-983-6336
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Provider Business Mailing Address
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Address Line | 412 8TH ST
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City | AUDUBON
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State | MN
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Zip | 56511-4224
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Country | US
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Telephone | 612-387-5584
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 00729
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License Number State | MN
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