Individual provider Active NPI

Paul Brian Sexton, LCSW

  • Clinical Social Worker
  • South Bend, IN
National Provider Identifier
1265914428
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9510-123 Issued in WI
Practice address
621 Memorial Dr Ste 402
South Bend, IN 46601-1074
Phone
(574) 280-8199
NPI assigned
Sep 4, 2018
Last updated
Aug 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 131117 WI
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 9510-123 WI Primary

Addresses

Primary practice location

621 Memorial Dr Ste 402
South Bend, IN 46601-1074

Mailing address

621 Memorial Dr Ste 402
South Bend, IN 46601-1074
Phone (574) 280-8199

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
I20210806000392 IN Practitioner - Clinical Social Worker 9638573082 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The South Bend Clinic LLCGroup PAC ID 3779577937, 171 clinicians

Practice addresses (Care Compare)

211 N Eddy St
South Bend, IN 46617-2808
Phone (574) 234-8161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
131117WIMDSocial Worker
9510-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The South Bend Clinic LLC Single Specialty CurrentSince Feb 1, 2024 Accepting new patients
Meridian Health Services Corp. CurrentSince Apr 7, 2024 Accepting new patients
The South Bend Clinic, LLC Single Specialty CurrentSince Feb 1, 2024 Accepting new patients
Healthlinc, Inc. Single Specialty Current Accepting new patients
Healthlinc, Inc CurrentSince Jul 30, 2021 Accepting new patients
Healthlinc, Inc CurrentSince Jul 30, 2021 Accepting new patients
Meridian Health Services Corp Single Specialty CurrentSince Apr 7, 2024 Accepting new patients
Family Psychology of South Bend LLC Clinical PastSince Sep 1, 2020 Accepting new patients

Locations

1313 W Chicago Ave
East Chicago, IN 46312
Phone (219) 397-1196

104 E Culver Rd
Ste 106
Knox, IN 46534
Phone (574) 772-7400

710 Franklin St
Ste 200
Michigan City, IN 46360
Phone (219) 872-6200

1818 Went Ave
Ste A
Mishawaka, IN 46545
Phone (574) 254-0229

420 W 4th St
Mishawaka, IN 46544
Phone (574) 252-0300

240 N Tillotson Ave
Muncie, IN 47304

1708 High St
South Bend, IN 46613
Phone (574) 237-6640

1960 Northside Blvd
South Bend, IN 46615
Phone (574) 231-7228

211 N Eddy St
South Bend, IN 46617
Phone (574) 237-9331

621 Memorial Dr
Ste 402
South Bend, IN 46601
Phone (574) 232-4800

1001 Sturdy Rd
Valparaiso, IN 46383
Phone (219) 462-7173

2401 Valley Dr
Valparaiso, IN 46383
Phone (219) 413-5100

701 Wall St
Valparaiso, IN 46383
Phone (219) 299-8419

Interoperability endpoints

  • FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/
  • Direct secure messaging: paul.sexton.p1@direct.meridianhs.nextgenshare.com

Organizations & group practices 8

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": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1265914428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 MEMORIAL DR STE 402",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011074",
            "telephone_number": "574-280-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MEMORIAL DR STE 402",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011074",
            "telephone_number": "574-280-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEXTON",
        "first_name": "PAUL",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-04",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "131117",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9510-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.