Individual provider Active NPI

Sara Ann Callison, LMSW, CAADC

  • Clinical Social Worker
  • Southgate, MI
National Provider Identifier
1154673564
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801110643 Issued in MI
Practice address
14799 Dix Toledo Rd
Southgate, MI 48195-2507
Phone
(734) 324-8326
NPI assigned
Oct 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X C-04395 MI
Addiction (Substance Use Disorder) Counselor 101YA0400X
Clinical Social Worker 1041C0700X 6801110643 MI Primary

Addresses

Primary practice location

14799 Dix Toledo Rd
Southgate, MI 48195-2507

Mailing address

1938 Moran Ave
Lincoln Park, MI 48146-3734
Phone (313) 721-7655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20190718003391 MI Practitioner - Clinical Social Worker 8325374911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Team Mental Health Services IncGroup PAC ID 2264451830, 33 clinicians

Practice addresses (Care Compare)

34290 Ford Rd
Westland, MI 48185-3051
Phone (734) 412-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-04395MIMDAddiction (Substance Use Disorder) Counselor
6801110643MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Team Mental Health Services Inc. CurrentSince Jul 15, 2021 Accepting new patients
Team Wellness Center CurrentSince Jul 15, 2021 Accepting new patients

Locations

921 Howard St
Dearborn, MI 48124
Phone (313) 274-3700

290 Town Center Dr
Ste 400
Dearborn, MI 48126
Phone (248) 763-5289

2925 Russell St
Detroit, MI 48207
Phone (313) 462-4714

14799 Dix Toledo Rd
Southgate, MI 48195
Phone (888) 813-8326

34290 Ford Rd
Westland, MI 48185
Phone (734) 412-8800

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": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1154673564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1938 MORAN AVE",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463734",
            "telephone_number": "313-721-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14799 DIX TOLEDO RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952507",
            "telephone_number": "734-324-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLISON",
        "first_name": "SARA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMSW, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "C-04395",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801110643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

Verify at the official NPI Registry.