Sara Peck, MSW, LISW-S

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

I.1450655-SUPV Issued in OH

Practice address

1925 Hayes Ave
Sandusky, OH 44870-4737

Phone

(419) 557-5177

Fax

(419) 557-5179

NPI assigned

Jun 22, 2012

Last updated

Dec 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Coast Professional Company, LLCGroup PAC ID 6305810201, 105 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• North Coast Professional Company, LLC

  • Internal Medicine Physician
  • Sandusky, OH
  • NPI 1881648210
  Medicare reassignment Care Compare group NPD
• North Coast Professional Company, LLC

  dba Firelands Physician Group

  • Rural Health Clinic/Center
  • Fremont, OH
  • NPI 1407393242
  NPD

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1457614604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 HAYES AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448703323",
            "telephone_number": "419-557-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 HAYES AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704737",
            "telephone_number": "419-557-5177",
            "fax_number": "419-557-5179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 Hayes Ave",
            "address_purpose": "LOCATION",
            "city": "Sandusky",
            "state": "OH",
            "postal_code": "448703323",
            "country_code": "US",
            "telephone_number": "419-557-7440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECK",
        "first_name": "SARA",
        "name_prefix": "Miss",
        "credential": "MSW, LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "I.1450655-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISW-S",
            "identifier": "I.1450655-SUPV",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bhairavi Patel
• Shailen R Patel, MD
• Pathlink of Ohio LLC
• Jennifer Rose Patrick
• Richard Alan Paulsen, PH.D.
• Peds on Wheels
• Jennifer Pelham
• Mark Pemberton
• Juan C Penhos, MD
• Angel M Pennix

• Mental Health Counselor in Sandusky, OH
• Providers in Sandusky, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.