Provider Demographics
NPI:1063044261
Name:VOELLER, SARAH (LICSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:VOELLER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 SHADYVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-2658
Mailing Address - Country:US
Mailing Address - Phone:715-577-3960
Mailing Address - Fax:
Practice Address - Street 1:6493 SYCAMORE CT N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-6028
Practice Address - Country:US
Practice Address - Phone:612-217-2578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN195221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical