Provider Demographics
NPI:1538367966
Name:DOLL, SARAH A (LPCC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:DOLL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W BURNSVILLE PKWY STE 207
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-0010
Mailing Address - Country:US
Mailing Address - Phone:612-642-1308
Mailing Address - Fax:952-686-6966
Practice Address - Street 1:101 W BURNSVILLE PKWY STE 207
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-0010
Practice Address - Country:US
Practice Address - Phone:612-642-1308
Practice Address - Fax:952-686-6966
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00247101YP2500X
MA47961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4796OtherLMHC
MNCC00247OtherLPCC