Individual provider Active NPI

Julie Marie Sasseen, LISW, MSW

  • Clinical Social Worker
  • Archbold, OH
National Provider Identifier
1417656703
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2204005 Issued in OH
Practice address
22251 State Route 2
Archbold, OH 43502-9452
Phone
(419) 445-1552
Fax
(419) 445-1401
NPI assigned
Feb 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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 I.2204005 OH Primary

Addresses

Primary practice location

22251 State Route 2
Archbold, OH 43502-9452

Mailing address

5030 County Road 15
Bryan, OH 43506-9767
Phone (419) 636-1713

Other practice location 1

428 Nicholas St
Defiance, OH 43512-1544
Phone (419) 956-1267

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20250205003721 OH Practitioner - Clinical Social Worker 6103356100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shalom MinistriesGroup PAC ID 7911376033, 7 clinicians

Practice addresses (Care Compare)

22251 State Route 2
Archbold, OH 43502-9452
Phone (419) 445-1552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.2204005OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Shalom Ministries CurrentSince Nov 16, 2024 Accepting new patients

Locations

22251 State Route 2
Archbold, OH 43502
Phone (419) 445-1552

5030 County Road 15
#C
Bryan, OH 43506
Phone (419) 636-1713

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": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1417656703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 COUNTY ROAD 15",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435069767",
            "telephone_number": "419-636-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22251 STATE ROUTE 2",
            "city": "ARCHBOLD",
            "state": "OH",
            "postal_code": "435029452",
            "telephone_number": "419-445-1552",
            "fax_number": "419-445-1401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "428 Nicholas St",
            "address_purpose": "LOCATION",
            "city": "Defiance",
            "state": "OH",
            "postal_code": "435121544",
            "country_code": "US",
            "telephone_number": "419-956-1267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SASSEEN",
        "first_name": "JULIE",
        "middle_name": "MARIE",
        "credential": "LISW, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2204005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Archbold, OH

Sources for this page

Verify at the official NPI Registry.