Individual provider Active NPI

Sara K McClam, LISW AP CP

  • Social Worker
  • Sumter, SC
National Provider Identifier
1063459642
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
001951 Issued in SC
Practice address
261 Broad Street
Sumter, SC 29150
Phone
(803) 775-3060
Fax
(803) 774-4280
NPI assigned
Jun 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 001951 SC Primary

Addresses

Primary practice location

261 Broad Street
Sumter, SC 29150

Mailing address

316 Running Fox Rd
Columbia, SC 29223
Phone (803) 960-3153

Other names 1

  • Ms. Sara M Mickelson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040224000277 SC Practitioner - Clinical Social Worker 7517853922 Practice locations: Sumter, SC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

261 Broad St
Sumter, SC 29150-4146
Phone (803) 775-3060

316 Running Fox Rd
Columbia, SC 29223-3060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001951SCMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Brain Center, PA PastSince Mar 1, 2007 Accepting new patients
Dermatology and Skin Surgery Inc PastSince Apr 1, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1063459642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 RUNNING FOX RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29223",
            "telephone_number": "803-960-3153",
            "fax_number": "803-905-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 BROAD STREET",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "29150",
            "telephone_number": "803-775-3060",
            "fax_number": "803-774-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLAM",
        "first_name": "SARA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "LISW AP CP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "001951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "MICKELSON",
            "middle_name": "M",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sumter, SC

Sources for this page

Verify at the official NPI Registry.