Individual provider Active NPI

Sara N Scruggs, LCSW

  • Clinical Social Worker
  • Princeton, IL
National Provider Identifier
1104482934
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.021155 Issued in IL
Practice address
28 E Marion St Ste 5
Princeton, IL 61356-2098
Phone
(815) 875-2192
NPI assigned
May 16, 2019
Last updated
Aug 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.021155 IL Primary

Addresses

Primary practice location

28 E Marion St Ste 5
Princeton, IL 61356-2098

Mailing address

909 W Central Ave
Princeton, IL 61356-1510
Phone (630) 476-7013

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

LicenseStateTypeSpecialty
149.021155ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New Directions Counseling Center Clinical CurrentSince Aug 23, 2020 Accepting new patients
New Directions Counseling Center PastSince Aug 23, 2020 Accepting new patients
Arukah Institute of Healing Inc NFP Clinical Past Accepting new patients

Locations

28 E Marion St
Ste 5
Princeton, IL 61356
Phone (815) 875-2192

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1104482934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 W CENTRAL AVE",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613561510",
            "telephone_number": "630-476-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 E MARION ST STE 5",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613562098",
            "telephone_number": "815-875-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCRUGGS",
        "first_name": "SARA",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-16",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.021155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.