Active NPI
Sara Elizabeth Walter Shihdanian, MS, LMHC
- Mental Health Counselor
- Detroit Lakes, MN
National Provider Identifier
1912404781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 60111072
- Practice address
- 843 Washington Ave Apt 202
Detroit Lakes, MN 56501-3057 - Phone
- (612) 963-3861
- NPI assigned
- Apr 9, 2018
- Last updated
- Sep 8, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 60111072 | WA | Primary |
| Mental Health Counselor | 101YM0800X | R5175 | OR |
Addresses
Primary practice location
843 Washington Ave Apt 202
Detroit Lakes, MN 56501-3057
Mailing address
1000 2ND Ave Ste 1770
Seattle, WA 98104-1046
Phone (458) 215-1812
Other names 1
- Sara Elizabeth Rundlett
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 31, 2024 through Jan 31, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R5175 | OR | MD | Mental Health Counselor |
| 60111072 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HIV Alliance | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757289600000",
"number": "1912404781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 2ND AVE STE 1770",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981041046",
"telephone_number": "458-215-1812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "843 WASHINGTON AVE APT 202",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565013057",
"telephone_number": "612-963-3861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTER SHIHDANIAN",
"first_name": "SARA",
"middle_name": "ELIZABETH",
"credential": "MS, LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-09",
"last_updated": "2025-09-08",
"certification_date": "2025-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "60111072",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "R5175",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SARA",
"last_name": "RUNDLETT",
"middle_name": "ELIZABETH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Detroit Lakes, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.