Provider Demographics
NPI:1245956754
Name:ROLLINS, SAHCAREION MATERIC (MA, LPCC)
Entity type:Individual
Prefix:
First Name:SAHCAREION
Middle Name:MATERIC
Last Name:ROLLINS
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 1:12685 GERMANE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-4375
Mailing Address - Country:US
Mailing Address - Phone:952-210-3592
Mailing Address - Fax:
Practice Address - Street 1:12751 COUNTY ROAD 5 STE 193
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-2283
Practice Address - Country:US
Practice Address - Phone:952-210-3592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3526101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional