Provider Demographics
NPI:1609932540
Name:KACHER, SANDRA M (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:M
Last Name:KACHER
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 1:1409 WILLOW ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-2269
Mailing Address - Country:US
Mailing Address - Phone:612-708-1742
Mailing Address - Fax:612-874-8612
Practice Address - Street 1:1409 WILLOW ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2269
Practice Address - Country:US
Practice Address - Phone:612-874-8608
Practice Address - Fax:612-874-8612
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN0019761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1790097327OtherNPI GROP NUMBER
800001233Medicare PIN