Individual provider Active NPI

Sara Becker, LCSW

  • Clinical Social Worker
  • Woodbridge, VA
National Provider Identifier
1487344248
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
21360 Issued in FL
Practice address
1141 Marseille LN
Woodbridge, VA 22191-3245
Phone
(443) 995-9540
NPI assigned
May 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 21360 FL Primary
Clinical Social Worker 1041C0700X 0904011353 VA

Addresses

Primary practice location

1141 Marseille LN
Woodbridge, VA 22191-3245

Mailing address

341 N Maitland Ave Ste 120
Maitland, FL 32751-4761
Phone (443) 995-9540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240621001194 FL Practitioner - Clinical Social Worker 8921541731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Live Oak Behavioral Health PAGroup PAC ID 9032525969, 6 clinicians

Practice addresses (Care Compare)

341 N Maitland Ave
Suite 120
Maitland, FL 32751-4761
Phone (407) 756-2084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21360FLMDClinical Social Worker
0904011353VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Live Oak Behavioral Health PA CurrentSince Jun 13, 2024 Accepting new patients

Locations

341 N Maitland Ave
Ste 120
Maitland, FL 32751
Phone (407) 756-2084

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": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1487344248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 N MAITLAND AVE STE 120",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514761",
            "telephone_number": "443-995-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 MARSEILLE LN",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913245",
            "telephone_number": "443-995-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "SARA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "21360",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904011353",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.