The Black Sheep Sanctuary PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

THE BLACK SHEEP SANCTUARY PLLC

Practice address

3080 Ogden Ave Ste 104
Lisle, IL 60532-1693

Phone

(630) 423-6244

NPI assigned

Mar 6, 2025

Organization subpart

No

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

Authorized official

Name

Samantha Vanderplow, LCSWNPI 1760139596

Title

Manager

Phone

(630) 709-1471

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samantha Vanderplow, LCSW

  • Clinical Social Worker
  • Lisle, IL
  • NPI 1760139596
  NPD Authorized official

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

{
    "created_epoch": "1741219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1457159386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 TERRACE DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601151936",
            "telephone_number": "630-709-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 OGDEN AVE STE 104",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321693",
            "telephone_number": "630-423-6244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BLACK SHEEP SANCTUARY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "VANDERPLOW",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "630-709-1471",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Lisle, IL
• Providers in Lisle, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.