Sandra Lee Tazelaar, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9454 Issued in MN

Practice address

1595 Selby Ave
Saint Paul, MN 55104

Phone

(651) 699-6480

Fax

(651) 699-4889

NPI assigned

Jun 16, 2006

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

• Sandra Lee Starn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Tazelaar Psychotherapy Services LLC

  • Clinical Social Worker
  • Saint Paul, MN
  • NPI 1811286594
  NPD (past) Authorized official
• Acupuncture and Chiropractic Limited, PLLC

  • Chiropractor
  • Saint Paul, MN
  • NPI 1396390050
  NPD (past)
• Charting Your Success LLC

  • Clinical Social Worker
  • Saint Paul, MN
  • NPI 1457602781
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1982648341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 SELBY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046221",
            "telephone_number": "651-699-6480",
            "fax_number": "651-699-4889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 SELBY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "651-699-6480",
            "fax_number": "651-699-4889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAZELAAR",
        "first_name": "SANDRA",
        "middle_name": "LEE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "9454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "STARN",
            "middle_name": "LEE",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sara Marie Taylor, PA-C
• Sheena Taylor
• Victoria Alexandra Taylor
• Wangchen Taythi
• Tazelaar Psychotherapy Services LLC
• Nicole Te Poel, M.D.
• Derek Techam, OTR/L
• Debbie Lynn Techar, LICSW
• David A Teeters, MD
• Fasika Tegegn

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, 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 Nov 14, 2016; 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.