Provider Demographics
NPI:1659191005
Name:NELSON, SARA FRANCES RIPP (LADC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:FRANCES RIPP
Last Name:NELSON
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7835 3RD ST N STE 207
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-5445
Mailing Address - Country:US
Mailing Address - Phone:651-297-6363
Mailing Address - Fax:
Practice Address - Street 1:7835 3RD ST N STE 207
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-5445
Practice Address - Country:US
Practice Address - Phone:651-297-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-11
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN307155101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)