Provider Demographics
NPI:1881351799
Name:BUMGARNER, SARAH ANN (MS, NCC, LPCC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:BUMGARNER
Suffix:
Gender:F
Credentials:MS, NCC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 KAREN LN
Mailing Address - Street 2:
Mailing Address - City:BIG LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55309
Mailing Address - Country:US
Mailing Address - Phone:763-334-8806
Mailing Address - Fax:
Practice Address - Street 1:407 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362-8815
Practice Address - Country:US
Practice Address - Phone:763-295-4001
Practice Address - Fax:763-295-5086
Is Sole Proprietor?:No
Enumeration Date:2021-11-26
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2965101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health