Provider Demographics
NPI:1932575594
Name:SARAH JOHNSTON LLC
Entity type:Organization
Organization Name:SARAH JOHNSTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:612-440-5707
Mailing Address - Street 1:4933 36TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-1514
Mailing Address - Country:US
Mailing Address - Phone:612-440-5707
Mailing Address - Fax:
Practice Address - Street 1:1854 GRAND AVE
Practice Address - Street 2:#200
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-1403
Practice Address - Country:US
Practice Address - Phone:612-440-5707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREGNANCY AND POSTPARTUM SUPPORT MINNESOTA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN206021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty