Provider Demographics
NPI:1598127698
Name:STAVER, SARA (LISW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:STAVER
Suffix:
Gender:
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1193 580TH ST
Mailing Address - Street 2:
Mailing Address - City:QUIMBY
Mailing Address - State:IA
Mailing Address - Zip Code:51049-7036
Mailing Address - Country:US
Mailing Address - Phone:712-229-7218
Mailing Address - Fax:
Practice Address - Street 1:1193 580TH ST
Practice Address - Street 2:
Practice Address - City:QUIMBY
Practice Address - State:IA
Practice Address - Zip Code:51049-7036
Practice Address - Country:US
Practice Address - Phone:712-229-7218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-28
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA12082101YA0400X
IA0869711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)