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General NPI Number Information
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NPI Number | 1801553276
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Entity Type | Individual
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Provider Name | SARA JANE WINKELMAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/20/2021
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 1609 S KIMBALL AVE STE 201
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City | CALDWELL
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State | ID
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Zip | 83605-5196
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Country | US
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Telephone | 208-899-8101
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Fax |
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Provider Business Mailing Address
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Address Line | 23258 HARTLEY LN
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City | MIDDLETON
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State | ID
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Zip | 83644-5108
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Country | US
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Telephone | 208-697-8467
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-41860
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | M7578
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License Number State | OR
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