Individual provider Active NPI

Sarah G Ridenour, LCSW

  • Clinical Social Worker
  • Naperville, IL
National Provider Identifier
1457562308
Registry record updated Jul 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-007369 Issued in IL
Practice address
43 E Jefferson Ave
Suite 201B
Naperville, IL 60540-4905
Phone
(630) 907-1735
Fax
(630) 907-1738
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2012

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 149-007369 IL Primary

Addresses

Primary practice location

43 E Jefferson Ave
Suite 201B
Naperville, IL 60540-4905

Mailing address

43 E Jefferson Ave
Suite 201B
Naperville, IL 60540-4905
Phone (630) 907-1735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20140612001094 IL Practitioner - Clinical Social Worker 6002030053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Waterford Counseling and Psychological Services PCGroup PAC ID 7012144017, 14 clinicians

Practice addresses (Care Compare)

1256 Waterford Dr
Suite 140
Aurora, IL 60504-4512
Phone (630) 898-5322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-007369ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Ridenour Counseling Services, P.C. Clinical Current Accepting new patients
Waterford Counseling and Psychological Services, PC Clinical CurrentSince Mar 1, 2014 Accepting new patients

Locations

1256 Waterford Dr
Ste 140
Aurora, IL 60504
Phone (630) 898-5322

Organizations & group practices 2

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341532800000",
    "number": "1457562308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 E JEFFERSON AVE",
            "address_2": "SUITE 201B",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605404905",
            "telephone_number": "630-907-1735",
            "fax_number": "630-907-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 E JEFFERSON AVE",
            "address_2": "SUITE 201B",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605404905",
            "telephone_number": "630-907-1735",
            "fax_number": "630-907-1738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDENOUR",
        "first_name": "SARAH",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2012-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-007369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.