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Provider Information for 1205427010


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SARAH ELIZABETH HABERMAN LICSW


Sex: Female

NPI: 1205427010
Last Updated: 2021-02-03
Certification Date: 2021-02-03

Details

NameValue
NPI1205427010
Enumeration Date2021-02-03
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 608 N OAKS DR APT 307
OSSEO, MN 55369-1456
United States

Phone: 763-464-3561 | Fax:
 
Primary Practice Address 13603 80TH CIR N
MAPLE GROVE, MN 55369-8961
United States

Phone: 763-274-3120 | Fax:763-274-3121
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalMN21510