Sarah Adele Roth, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

29971 Issued in MN

Practice address

1435 White Oak Dr Ste 200
Chaska, MN 55318-2567

Phone

(952) 443-4600

Fax

(952) 443-4604

NPI assigned

Oct 6, 2023

Last updated

Oct 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1696550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1700667748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 WHITE OAK DR STE 200",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553182567",
            "telephone_number": "952-443-4600",
            "fax_number": "952-443-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 WHITE OAK DR STE 200",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553182567",
            "telephone_number": "952-443-4600",
            "fax_number": "952-443-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "SARAH",
        "middle_name": "ADELE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-06",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29971",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": "29971",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abby Rohlik
• Stephen Thomas Root, OTR
• Rebecca Ann Rosdahl, PHARMD
• Alexander Ross, PHARMD
• Maura Collins Ross, CNP
• Brittney Royer
• Jenny Rebecca Ruoho, D.D.S.
• Lorene Elaine Rutherford, M.D.
• Ponciana W Sajulga, RN
• Michael Sala, LICSW

• Clinical Social Worker in Chaska, MN
• Providers in Chaska, 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 Oct 25, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.