Provider Demographics
NPI:1417535394
Name:STRUCKMAN, SARA LYNN (CSW-PIP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:LYNN
Last Name:STRUCKMAN
Suffix:
Gender:F
Credentials:CSW-PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 3RD AVE NW
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-2311
Mailing Address - Country:US
Mailing Address - Phone:605-886-5262
Mailing Address - Fax:605-886-5228
Practice Address - Street 1:120 3RD AVE NW
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-2311
Practice Address - Country:US
Practice Address - Phone:605-886-5262
Practice Address - Fax:605-886-5228
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6496104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker