Individual provider Active NPI

Sarah Kathryn Jackson

  • Social Worker
  • Minneapolis, MN
National Provider Identifier
1326667023
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
3548 Bryant Ave S
Minneapolis, MN 55408-4119
Phone
(612) 822-8227
NPI assigned
Apr 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 29795 MN
Social Worker 104100000X Primary

Addresses

Primary practice location

3548 Bryant Ave S
Minneapolis, MN 55408-4119

Mailing address

3548 Bryant Ave S
Minneapolis, MN 55408-4119
Phone (612) 822-8227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251028004743 MN Practitioner - Clinical Social Worker 7911496120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4912 32ND Ave S
Minneapolis, MN 55417-1410

653 Grand Ave
Saint Paul, MN 55105-3401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29795MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wild Tree Psychotherapy, LLC CurrentSince Sep 16, 2025 Accepting new patients
Savio House, Inc. Social Worker PastSince Apr 1, 2020 Accepting new patients
Life Works Counseling Social Worker PastSince Nov 19, 2023 Accepting new patients
Watercourse Counseling Center PastSince Oct 6, 2024 Accepting new patients
The Mental Health Collective PastSince Oct 6, 2024 Accepting new patients
Sarah C. Chambers, P.a. Past Accepting new patients

Locations

1519 Central Pkwy
Ste 260
Eagan, MN 55121
Phone (612) 578-6001

653 Grand Ave
Saint Paul, MN 55105
Phone (651) 212-4920

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1326667023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3548 BRYANT AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084119",
            "telephone_number": "612-822-8227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3548 BRYANT AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084119",
            "telephone_number": "612-822-8227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SARAH",
        "middle_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29795",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.