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NPI Code Detail

MEDICARE: SARA WERNER MA, LP, RPT-S, SEP

MEDICARE: SARA WERNER MA, LP, RPT-S, SEP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC1900XCounseling PsychologistLP4967MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1336R1REOTHERMNBCBS ID#
255042A006OTHERTRIWEST/TRICARE
3808194000OTHERMNMAGELLAN/AETNA ID#
4HP11294OTHERMNHEALTH PARTNERS ID#

General Provider Information

NPI Number : 1508855586
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA WERNER MA, LP, RPT-S, SEP
Provider Business Mailing Address
First Line : 4255 PHEASANT RIDGE DR NE STE 412
Second Line :
City : BLAINE
State : MN
Zip : 55449-5066
Country : US
Telephone Number : 651-503-7870
Fax Number : 763-402-7602
Provider Business Practice Location Address
First Line : 4255 PHEASANT RIDGE DR NE STE 412
Second Line :
City : BLAINE
State : MN
Zip : 55449-5066
Country : US
Telephone Number : 763-703-3753
Fax Number : 763-703-3753
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 05/22/2026

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Directions to “ SARA WERNER MA, LP, RPT-S, SEP” Practice Location

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