Provider Demographics
NPI:1912186958
Name:KASMER, SARA E (LSW)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:E
Last Name:KASMER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 19TH AVE W
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-6506
Mailing Address - Country:US
Mailing Address - Phone:701-570-8148
Mailing Address - Fax:
Practice Address - Street 1:1135 2ND AVE W STE 202
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-4175
Practice Address - Country:US
Practice Address - Phone:701-572-7650
Practice Address - Fax:701-572-7656
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4169104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker