MEDICARE: SARA HALVERSON

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
1	101YP2500X	Professional Counselor	03063	MN

General Provider Information

NPI Number	:	1932067626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA HALVERSON

Provider Business Mailing Address
First Line	:	1694 IVORY AVE N
Second Line	:
City	:	LAKE ELMO
State	:	MN
Zip	:	55042-9309
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1903 GREELEY ST S STE 202
Second Line	:
City	:	STILLWATER
State	:	MN
Zip	:	55082-6279
Country	:	US
Telephone Number	:	651-504-4006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “ SARA HALVERSON ” Practice Location

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