Active NPI
Sara Lynn Irwin, LMHP, PLADC
- Counselor
- Boys Town, NE
National Provider Identifier
1184984361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 3880
- Practice address
- 13460 Walsh Dr
Boys Town, NE 68010-7529 - Phone
- (402) 498-3358
- Fax
- (402) 498-3375
- NPI assigned
- May 22, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 3880 | NE | Primary |
Addresses
Primary practice location
13460 Walsh Dr
Boys Town, NE 68010-7529
Mailing address
13460 Walsh Dr
Boys Town, NE 68010-7529
Phone (402) 498-3358
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100261397-00 | Medicaid | NE | |
| 470376606-31 | Medicaid | NE |
Other names 1
- Sara Lynn Shaffer
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA, MO, TX, NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2008
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3880 | NE | MD | Mental Health Counselor |
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": "1337644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364342400000",
"number": "1184984361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13460 WALSH DR",
"city": "BOYS TOWN",
"state": "NE",
"postal_code": "680107529",
"telephone_number": "402-498-3358",
"fax_number": "402-498-3375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13460 WALSH DR",
"city": "BOYS TOWN",
"state": "NE",
"postal_code": "680107529",
"telephone_number": "402-498-3358",
"fax_number": "402-498-3375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRWIN",
"first_name": "SARA",
"middle_name": "LYNN",
"credential": "LMHP, PLADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-22",
"last_updated": "2013-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NE",
"license": "3880",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100261397-00",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "470376606-31",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SARA",
"last_name": "SHAFFER",
"middle_name": "LYNN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Boys Town, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.