Provider Demographics
NPI:1891918363
Name:MEUTH, SARA C (MSW APSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:C
Last Name:MEUTH
Suffix:
Gender:F
Credentials:MSW APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 FALCON PL
Mailing Address - Street 2:
Mailing Address - City:NEW RICHMOND
Mailing Address - State:WI
Mailing Address - Zip Code:54017-6588
Mailing Address - Country:US
Mailing Address - Phone:715-246-6028
Mailing Address - Fax:
Practice Address - Street 1:100 POLK COUNTY PLZ
Practice Address - Street 2:SUITE 50
Practice Address - City:BALSAM LAKE
Practice Address - State:WI
Practice Address - Zip Code:54810-9071
Practice Address - Country:US
Practice Address - Phone:715-485-8488
Practice Address - Fax:715-485-8490
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1865 121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31876OtherHEALTH PARTNERS INSURANCE
WI127T3MEOtherBCBS MN INSURANCE
WI40926200Medicaid
WIP 12027499OtherWPPN INSURANCE
WI1606606OtherARAZ INSURANCE
WI40926200Medicaid
WIP 12027499OtherWPPN INSURANCE