Larson, Joan Sagedahl
Larson, Joan Sagedahl is an individual health care provider with primary practice located at 1280 North Birch Lake Blvd White Bear Lake Area Community Counseling Center, White Bear Lake MN 55110-6708. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Larson, Joan Sagedahl can be contacted via phone (651) 429-8544.Contact Information
Primary practice address
1280 North Birch Lake Blvd White Bear Lake Area Community Counseling Center
White Bear Lake MN 55110-6708
Phone: (651) 429-8544
Fax: (651) 407-5301
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 06420 | Minnesota |
Profile Details
| NPI number | 1740352921 |
|---|---|
| LBN Legal business name | Larson, Joan Sagedahl |
| Credentials | MSSA LICSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 14th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740352921 | NPPES |
| Minnesota | Other | 104651 | UCARE MINNESOTA |
| Minnesota | Other | 40115 | UCARE MINNESOTA |
| Minnesota | Other | 5H417LA | UCARE MINNESOTA |
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