Individual provider Active NPI

Sally McMahan, LCSW

  • Clinical Social Worker
  • Greenwood, IN
National Provider Identifier
1245562487
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34002272A Issued in IN
Practice address
1649 Pinecone LN W Apt M
Greenwood, IN 46143-2183
Phone
(317) 200-1310
Fax
(765) 964-4300
NPI assigned
Feb 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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 34002272A IN Primary

Addresses

Primary practice location

1649 Pinecone LN W Apt M
Greenwood, IN 46143-2183

Mailing address

1649 Pinecone LN W Apt M
Greenwood, IN 46143-2183
Phone (317) 200-1310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20040615000411 IN Practitioner - Clinical Social Worker 9133103583 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34002272AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sanders and Associates. LLC Clinical CurrentSince May 15, 2021 Accepting new patients
Psychological Laboratories of Indianapolis, PC Past Accepting new patients
Green House and Associates Inc Clinical PastSince Nov 1, 2010 Accepting new patients
Hedgehog Psychiatric Clinical Past Accepting new patients
Castle Counseling Center, LLC Past Accepting new patients

Locations

5555 N Tacoma Ave
Ste 204
Indianapolis, IN 46220
Phone (317) 257-7434

Organizations & group practices 5

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": "1265932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1245562487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1649 PINECONE LN W APT M",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461432183",
            "telephone_number": "317-200-1310",
            "fax_number": "765-964-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1649 PINECONE LN W APT M",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461432183",
            "telephone_number": "317-200-1310",
            "fax_number": "765-964-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHAN",
        "first_name": "SALLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-12",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34002272A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.