Sharon Sacks, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

20041854A Issued in IN

Practice address

1411 S Woodland Ave
Ste B
Michigan City, IN 46360-7169

Phone

(219) 210-0111

Fax

(219) 879-2887

NPI assigned

Jun 28, 2006

Last updated

Apr 5, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Clinical Psychologist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sacks Clinical Consulting, PCGroup PAC ID 9335320134, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Sacks Clinical Consulting, PC

  • Counseling Psychologist
  • Michigan City, IN
  • NPI 1548567241
  Medicare reassignment Care Compare group NPD Authorized official
• Virtual Consult MD LLC

  • Psychiatry Physician
  • Evansville, IN
  • NPI 1871966523
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270425600000",
    "number": "1437187606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1083",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463618283",
            "telephone_number": "219-926-8320",
            "fax_number": "219-926-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 S WOODLAND AVE",
            "address_2": "STE B",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607169",
            "telephone_number": "219-210-0111",
            "fax_number": "219-879-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKS",
        "first_name": "SHARON",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2010-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20041854A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "000000392276",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAGAMORE HEALTH PLAN",
            "identifier": "202655005 01",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Roy, PHARMD
• RS Physical Therapy Co
• Olivia Rudnicki
• Nathanael Rumba, CRNA
• Sacks Clinical Consulting, PC
• Sacred Dunes Integrative Health
• Hamid Safavi, MD
• Safe Step Medical Supplies
• Audrie E. Safrithis, CRNA
• James Safrithis

• Psychologist in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.