Individual provider Active NPI

Sara Nichole Barrientos, LCSW

  • Clinical Social Worker
  • Rushville, IL
National Provider Identifier
1215693254
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149018318 Issued in IL
Practice address
12101 Pokeberry Rd
Rushville, IL 62681-4778
Phone
(217) 248-3077
NPI assigned
Nov 15, 2021
Last updated
Nov 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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 149018318 IL Primary

Addresses

Primary practice location

12101 Pokeberry Rd
Rushville, IL 62681-4778

Mailing address

12101 Pokeberry Rd
Rushville, IL 62681-4778
Phone (217) 248-3077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20231017003899 IL Practitioner - Clinical Social Worker 5890140487 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149018318ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Schuyler County Hospital District CurrentSince Jul 31, 2023 Accepting new patients
Schuyler County Hospital District CurrentSince Jul 31, 2023 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Aug 18, 2023 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

238 S Congress St
Rushville, IL 62681
Phone (217) 322-4321

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": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1215693254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12101 POKEBERRY RD",
            "city": "RUSHVILLE",
            "state": "IL",
            "postal_code": "626814778",
            "telephone_number": "217-248-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12101 POKEBERRY RD",
            "city": "RUSHVILLE",
            "state": "IL",
            "postal_code": "626814778",
            "telephone_number": "217-248-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRIENTOS",
        "first_name": "SARA",
        "middle_name": "NICHOLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rushville, IL

Sources for this page

Verify at the official NPI Registry.