Individual provider Active NPI

Sara L McClellin, LCSW

  • Clinical Social Worker
  • Caldwell, ID
National Provider Identifier
1417398140
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2006 Blaine St
Caldwell, ID 83605-4343
Phone
(208) 454-3430
Fax
(208) 453-6493
NPI assigned
Jul 10, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary
Clinical Social Worker 1041C0700X 35506 ID

Addresses

Primary practice location

2006 Blaine St
Caldwell, ID 83605-4343

Mailing address

2006 Blaine St
Caldwell, ID 83605-4343
Phone (208) 454-3430

Other identifiers 3

IdentifierTypeStateIssuer
1417398140MedicaidID
126556547MedicaidID
1710427513OtherTYPE II NPI

Other names 1

  • Sara McClellin Professional name

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
I20140807000978 ID Practitioner - Clinical Social Worker 5294952743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2006 Blaine St
Caldwell, ID 83605-4343
Phone (208) 454-3430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lotus Counseling Services, LLC Clinical CurrentSince Jan 30, 2017 Accepting new patients

Locations

2006 Blaine St
Caldwell, ID 83605
Phone (208) 454-3430

107 S Kimball Ave
Ste 225
Caldwell, ID 83605
Phone (208) 727-7070

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": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1417398140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 BLAINE ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054343",
            "telephone_number": "208-454-3430",
            "fax_number": "888-972-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 BLAINE ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054343",
            "telephone_number": "208-454-3430",
            "fax_number": "208-453-6493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLIN",
        "first_name": "SARA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-10",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "35506",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417398140",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126556547",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE II NPI",
            "identifier": "1710427513",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "MCCLELLIN",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.