Provider Demographics
NPI:1801553276
Name:WINKELMAN, SARA JANE (LCSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:JANE
Last Name:WINKELMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23258 HARTLEY LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:ID
Mailing Address - Zip Code:83644-5108
Mailing Address - Country:US
Mailing Address - Phone:208-697-8467
Mailing Address - Fax:
Practice Address - Street 1:1609 S KIMBALL AVE STE 201
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-5196
Practice Address - Country:US
Practice Address - Phone:208-899-8101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-20
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-418601041C0700X
ORM7578101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health