Sarah Jane Evergreen, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

2019020234 Issued in MO

Practice address

1295 Bandana Blvd N Ste 210
Saint Paul, MN 55108-5115

Phone

(888) 272-0784

NPI assigned

May 26, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Sarah Jane Benkendorf Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1962025833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 COLOGNE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631161316",
            "telephone_number": "314-437-3402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 BANDANA BLVD N STE 210",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085115",
            "telephone_number": "888-272-0784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERGREEN",
        "first_name": "SARAH",
        "middle_name": "JANE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2019020234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "BENKENDORF",
            "middle_name": "JANE",
            "credential": "LMSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Evergreen Health Services PLC
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• Evergreen Mental Health Services, Inc
• Evergreen Recovery
• Evergreen Recovery Clinical Laboratory
• Charles Everingham
• Rachel Everson-Fink, CCC-SLP
• Evoke Therapy Services, LLC
• Evolve Mental Health
• David Ewart, M.D.

• Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.