Individual provider Active NPI

Sarah E Hlebichuk, LCSW

  • Clinical Social Worker
  • Hayden, ID
National Provider Identifier
1285985101
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-35594 Issued in ID
Practice address
21 W Commerce Dr Ste F
Hayden, ID 83835-9289
Phone
(208) 704-0046
NPI assigned
Oct 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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 LCSW-35594 ID Primary
Social Worker 104100000X LMSW-29995 ID

Addresses

Primary practice location

21 W Commerce Dr Ste F
Hayden, ID 83835-9289

Mailing address

PO Box 895
Hayden, ID 83835-0895

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20230316001725 ID Practitioner - Clinical Social Worker 5496129348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21 W Commerce Dr
Suite F
Hayden, ID 83835-9289
Phone (208) 704-0046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-29995IDMDSocial Worker
LCSW-35594IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lakehaven Counseling PLLC Social Worker CurrentSince Nov 24, 2022 Accepting new patients

Locations

21 W Commerce Dr
Ste F
Hayden, ID 83835
Phone (208) 704-0046

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": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1285985101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 895",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838350895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W COMMERCE DR STE F",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838359289",
            "telephone_number": "208-704-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HLEBICHUK",
        "first_name": "SARAH",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-35594",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-29995",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayden, ID

Sources for this page

Verify at the official NPI Registry.