Provider Demographics
NPI:1487202495
Name:LOCKHART, SARAH ANNE (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANNE
Other - Last Name:LOCKHART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LICSW
Mailing Address - Street 1:2502 10TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-4510
Mailing Address - Country:US
Mailing Address - Phone:612-813-8300
Mailing Address - Fax:612-813-8330
Practice Address - Street 1:2502 10TH AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4510
Practice Address - Country:US
Practice Address - Phone:612-813-8300
Practice Address - Fax:612-813-8330
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN211901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical