Sarah Ann Connell, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2377 Issued in MN

Practice address

1904 30TH Ave S
Moorhead, MN 56560-5210

Phone

(218) 325-0069

NPI assigned

Jan 15, 2020

Sex

Female

Sole proprietor

No

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

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eclectic Therapy Collective PLLCGroup PAC ID 5698254498, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eclectic Therapy Collective PLLC

  • Professional Counselor
  • Moorhead, MN
  • NPI 1366322000
  Medicare reassignment Care Compare group NPD Authorized official
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD
• Renew Medical Clinic LLC

  • Pain Medicine (Anesthesiology) Physician
  • Fargo, ND
  • NPI 1811234032
  NPD (past)

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1699315838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 30TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605210",
            "telephone_number": "218-325-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 30TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605210",
            "telephone_number": "218-325-0069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1132 28th Ave S Ste 102",
            "address_purpose": "LOCATION",
            "city": "Moorhead",
            "state": "MN",
            "postal_code": "565604420",
            "country_code": "US",
            "telephone_number": "218-227-5376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "SARAH",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "2377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cassandra Costa, ND
• Tyza Kay Coster
• Marrissa Couillard

• Professional Counselor in Moorhead, MN
• Providers in Moorhead, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.