Individual provider Active NPI

Sarah Marie Fogelman, LICSW

  • Clinical Social Worker
  • Burnsville, MN
National Provider Identifier
1770445868
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
30213 Issued in MN
Practice address
14041 Burnhaven Dr Ste 125
Burnsville, MN 55337-4408
Phone
(612) 702-6012
NPI assigned
Nov 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 30213 MN Primary

Addresses

Primary practice location

14041 Burnhaven Dr Ste 125
Burnsville, MN 55337-4408

Mailing address

14041 Burnhaven Dr Ste 125
Burnsville, MN 55337-4408

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
I20260129002403 MN Practitioner - Clinical Social Worker 7315425519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14041 Burnhaven Dr
Suite 125
Burnsville, MN 55337-4408

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30213MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Luna Therapy Services CurrentSince Jan 5, 2026 Accepting new patients

Locations

14041 Burnhaven Dr
Ste 125
Burnsville, MN 55337
Phone (612) 440-8750

Organizations & group practices 1

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": "1764115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1770445868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14041 BURNHAVEN DR STE 125",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14041 BURNHAVEN DR STE 125",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374408",
            "telephone_number": "612-702-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGELMAN",
        "first_name": "SARAH",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-26",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "30213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

Verify at the official NPI Registry.