Active NPI
Sarah Wiese
- Clinical Social Worker
- Dearborn, MI
National Provider Identifier
1023663457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6851110096
- Practice address
- 19855 Outer Dr Ste 300
Dearborn, MI 48124-2022 - Phone
- (313) 359-1977
- NPI assigned
- Aug 2, 2019
- Last updated
- Jun 6, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6851110096 | MI | Primary |
Addresses
Primary practice location
19855 Outer Dr Ste 300
Dearborn, MI 48124-2022
Mailing address
19855 Outer Dr Ste 300
Dearborn, MI 48124-2022
Phone (313) 359-1977
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6851110096 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| ABA Pathways, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- NPI 1770838468
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717632000000",
"number": "1023663457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19855 OUTER DR STE 300",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481242022",
"telephone_number": "313-359-1977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19855 OUTER DR STE 300",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481242022",
"telephone_number": "313-359-1977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIESE",
"first_name": "SARAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-02",
"last_updated": "2024-06-06",
"certification_date": "2024-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6851110096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.