Provider Demographics
NPI:1316582539
Name:COOK, SARAH ANNE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANNE
Last Name:COOK
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:ANNE
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SARAH MCCORMICK
Mailing Address - Street 1:501 HIGHWAY 13 E STE 116
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-2877
Mailing Address - Country:US
Mailing Address - Phone:651-728-0414
Mailing Address - Fax:651-681-9317
Practice Address - Street 1:501 HIGHWAY 13 E STE 116
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-2877
Practice Address - Country:US
Practice Address - Phone:651-728-0414
Practice Address - Fax:651-681-9317
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN133911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical