Provider Demographics
NPI:1760945539
Name:SAPPHIRE COUNSELING & THERAPEUTIC SERVICES PLLC
Entity Type:Organization
Organization Name:SAPPHIRE COUNSELING & THERAPEUTIC SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRADER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:612-221-5476
Mailing Address - Street 1:804 BRADBURY CIR
Mailing Address - Street 2:
Mailing Address - City:JORDAN
Mailing Address - State:MN
Mailing Address - Zip Code:55352-1466
Mailing Address - Country:US
Mailing Address - Phone:612-221-5476
Mailing Address - Fax:
Practice Address - Street 1:100 OAK AVE SW STE 4
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:MN
Practice Address - Zip Code:56069-1243
Practice Address - Country:US
Practice Address - Phone:952-444-9771
Practice Address - Fax:952-444-9771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty