Sara Shotsberger, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.015695 Issued in IL

Practice address

3707 W Cullom Ave
Chicago, IL 60618-2004

Phone

(312) 532-8553

Fax

(312) 532-8553

NPI assigned

Mar 14, 2013

Last updated

Feb 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Humble Haven Chicago

  • Clinical Social Worker
  • Downers Grove, IL
  • NPI 1912599242
  NPD Authorized official
• Humble Haven Homestead

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Three Oaks, MI
  • NPI 1457123911
  NPD Authorized official

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1154662104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 W CULLOM AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606182004",
            "telephone_number": "312-927-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 W CULLOM AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606182004",
            "telephone_number": "312-532-8553",
            "fax_number": "312-532-8553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOTSBERGER",
        "first_name": "SARA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-14",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yosef Shoshana, PSYD
• Ohad Shoshany, M.D.
• Daniel Shotaro-Nakaji Monnier, RN
• Jared Shotel
• Shotfairy.Com LLC
• Chelsea Shotwell Tabke, PHD
• Martina Shoukralla, MD
• Carissa Shoultz, RBT-17-38260
• Alissa Shoup, PHARM D
• Sami J. Shoura, MD

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.