Sara Champie
Individual provider Active NPI Clinical Social Worker · Sebastopol, CA
NPI 1013303809 · NPPES record last updated Jul 30, 2019
Key facts
- NPI
- 1013303809
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 87702 (CA)
- Practice address
- 435 Petaluma Ave Ste 140
Sebastopol, CA 95472-4273 - Phone
- (707) 861-0577
- NPI assigned
- Apr 8, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2025 through Jul 1, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 87702 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psych Strategies Inc a Psychological Corp | Past |
Accepting new patients | |
| Redwood Valley Health Clinic, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | 65842 | CA | |
| Social Worker | 104100000X | 65842 | CA | |
| Clinical Social Worker | 1041C0700X | 87702 | CA | Yes |
Addresses
Primary practice location
435 Petaluma Ave Ste 140
Sebastopol, CA 95472-4273
Mailing address
PO Box 472
Sebastopol, CA 95473-0472
Phone (707) 861-0577
Other providers in Sebastopol, CA
- Megan Carlock
- Mary Ann Carpenter
- Miranda Natalia Carpenter
- Anne Casey-Nielson
- Emilce Castro Deller
- Charlene Renee Chan
- Valerie Chan
- Margaret B Chandler
- Charles N Harris PHD a Psychological Corp
- Geetinder Kaur Chattha
All providers in Sebastopol, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.