Individual
SARA WERNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LP, RPT-S, SEP
Contact information
Practice address
4255 PHEASANT RIDGE DR NE STE 412, BLAINE, MN 55449-5066
(763) 703-3753
(763) 703-3753
Mailing address
4255 PHEASANT RIDGE DR NE STE 412, BLAINE, MN 55449-5066
(763) 703-3753
(763) 703-3725
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
LP4967
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
336R1RE
BCBS ID#
MN
01
—
55042A006
TRIWEST/TRICARE
—
01
—
808194000
MAGELLAN/AETNA ID#
MN
01
—
HP11294
HEALTH PARTNERS ID#
MN
Enumeration date
10/20/2005
Last updated
05/17/2022
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