Sara Elizabeth Citrine, CHW

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

3130 SE 2ND Ave
Grand Rapids, MN 55744

Phone

(218) 256-1131

NPI assigned

Jun 27, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Northland Counseling Center, Inc.

  • Community/Behavioral Health Agency
  • Grand Rapids, MN
  • NPI 1164610986
  NPD (past)

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1982199410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WILLOW LN",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443939",
            "telephone_number": "218-256-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 SE 2ND AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "55744",
            "telephone_number": "218-256-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CITRINE",
        "first_name": "SARA",
        "middle_name": "ELIZABETH",
        "credential": "CHW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Raquel Childs
• Suzette Childs, RN BSN CDE CPT
• Angela Danette Christian, PMHNP
• James Dale Christian, MS. ED., LMFT
• Danielle Christopherson, LICSW
• Clearwater Mental Health & Wellness
• Cathy J. Cleary, MD
• Kara Michele Clifton
• Craig Close
• Jessica Coburn, MSW, LICSW

• Community Health Worker in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Community Health Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.