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SARAH J GUBBELS LICSW
>> Social Worker >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1043532252
Individual Registrant: SARAH J GUBBELS LICSW
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
600 MAIN AVE S BAUDETTE, MN 56623-2855 US
Tel: 218-634-2120 Fax: --
Tel: 218-634-2120 Fax: --
Contact information for business:
600 MAIN AVE S BAUDETTE, MN 56623-2855 US
Tel: 218-634-1655 Fax: 218-634-1094
Tel: 218-634-1655 Fax: 218-634-1094
Registration Information:
NPI: 1043532252
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 104100000X | Behavioral Health & Social Service Providers Social Worker | ND | 4252 |
| N | 1041C0700X | Behavioral Health & Social Service Providers Social Worker | MT | SWP-LCSW-LIC-4644 |
| N | 1041C0700X | Behavioral Health & Social Service Providers Social Worker | ND | 4252 |
| Y | 1041C0700X | Behavioral Health & Social Service Providers Social Worker | MN | 30072 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| BLUE CROSS/BLUE SHIELD OF ND | 1043532252 | ND | 01 |
| 19308 | ND | 05 | |
| 74133 | ND | 05 |
