Sacks Clinical Consulting, PC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

20041854A Issued in IN

Legal business name

SACKS CLINICAL CONSULTING, PC

Practice address

107 Woodland CT
Ste B
Michigan City, IN 46360-7392

Phone

(219) 628-6463

Fax

(219) 809-0200

NPI assigned

Feb 16, 2011

Last updated

Feb 22, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sharon Sacks, PHDNPI 1437187606

Title

Owner

Phone

(219) 210-0111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sharon Sacks, PHD

  • Psychologist
  • Michigan City, IN
  • NPI 1437187606
  Medicare reassignment Care Compare group NPD Authorized official
• Jeffrey Samelson, PHD

  • Clinical Psychologist
  • Michigan City, IN
  • NPI 1801866223
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298332800000",
    "number": "1548567241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WOODLAND CT",
            "address_2": "STE B",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607392",
            "telephone_number": "219-628-6463",
            "fax_number": "219-809-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WOODLAND CT",
            "address_2": "STE B",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607392",
            "telephone_number": "219-628-6463",
            "fax_number": "219-809-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACKS CLINICAL CONSULTING, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-16",
        "last_updated": "2011-02-22",
        "status": "A",
        "authorized_official_last_name": "SACKS",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-210-0111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IN",
            "license": "20041854A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia S Rothchild, APRN, FNP-BC, NP-C
• Elizabeth Roy, PHARMD
• RS Physical Therapy Co
• Olivia Rudnicki
• Nathanael Rumba, CRNA
• Sharon Sacks, PHD
• Sacred Dunes Integrative Health
• Hamid Safavi, MD
• Safe Step Medical Supplies
• Audrie E. Safrithis, CRNA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.