Individual provider Active NPI

Sarah Nicole Komindo, LCSW

  • Clinical Social Worker
  • Battle Creek, MI
National Provider Identifier
1154703981
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801108482 Issued in MI
Practice address
5500 Armstrong Rd
Battle Creek, MI 49037-7314
Phone
(269) 966-5600
NPI assigned
Jun 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904009058 VA
Clinical Social Worker 1041C0700X 6801108482 MI Primary

Addresses

Primary practice location

5500 Armstrong Rd
Battle Creek, MI 49037-7314

Mailing address

5500 Armstrong Rd
Battle Creek, MI 49037-7314
Phone (269) 966-5600

Other names 1

  • Sarah Nicole Paulin Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801108482MIMDClinical Social Worker
0904009058VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Counseling Center, Inc. Clinical PastSince Nov 16, 2013 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1154703981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 ARMSTRONG RD",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490377314",
            "telephone_number": "269-966-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 ARMSTRONG RD",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490377314",
            "telephone_number": "269-966-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMINDO",
        "first_name": "SARAH",
        "middle_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009058",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801108482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "PAULIN",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.