SARA PROVO LPCC NPI 1912582354

NPI Information

NPI: 1912582354
Provider Name: SARA PROVO, LPCC
Classification: Counselor - 101YM0800X
Specialization: Mental Health
Entity Type: Individual
Address: 1772 STIEGER LAKE LN STE 220
VICTORIA, MN
ZIP 55386
Phone: (952) 443-4600

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NPI Details

Sara Provo, LPCC is a mental health counselor in Victoria, MN. Sara Provo, LPCC NPI is 1912582354. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1772 STIEGER LAKE LN STE 220
VICTORIA, MN
ZIP 55386-723
Phone: (952) 443-4600
Fax: (952) 443-4604

The enumeration date for this NPI number is 3/17/2021 and was last updated on 4/6/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	2765	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	LPCC2765	OTHER	MINNESOTA	MN BOARD OF BH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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