Provider Demographics
NPI:1821609371
Name:HARRY, SARAH (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:HARRY
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8922 UMBRIA PL N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-1107
Mailing Address - Country:US
Mailing Address - Phone:612-812-4347
Mailing Address - Fax:
Practice Address - Street 1:21370 JOHN MILLESS DR STE 106
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:MN
Practice Address - Zip Code:55374-4622
Practice Address - Country:US
Practice Address - Phone:612-812-4347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2559101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional