Sarah Renee June Sumner, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

27915 Issued in MN

Practice address

657 Main St NW Ste 208
Elk River, MN 55330-1517

Phone

(612) 412-1136

NPI assigned

Feb 19, 2019

Last updated

Jun 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindful Connection Therapy

  • Clinical Social Worker
  • Elk River, MN
  • NPI 1790418267
  Authorized official Same address or phone
• Lee Carlson Center for Mental Health and Well-Being

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fridley, MN
  • NPI 1457455057
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1265998819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 MAIN ST NW STE 208",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301517",
            "telephone_number": "612-412-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 MAIN ST NW STE 208",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301517",
            "telephone_number": "612-412-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMNER",
        "first_name": "SARAH",
        "middle_name": "RENEE JUNE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-19",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "27915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Steve
• Jacob Stevens, PHARM D
• Stacy Ann Stroh, M.S. CCC-SLP
• Adam Charles Stumne, DC
• Summit Orthopedics, LTD
• Jamie Sunnarborg
• Supervalu Pharmacies Inc (Cub Pharmacy)
• Danielle Marie Swader
• Tabitha Carlie Szulga
• Jocelyn Savai Talso

• Clinical Social Worker in Elk River, MN
• Providers in Elk River, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.