Active NPI
Sarah Collinsworth
- Professional Counselor
- Springfield, OH
National Provider Identifier
1558808154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E.2001748
- Practice address
- 2624 Lexington Ave
Springfield, OH 45505-2620 - Phone
- (937) 328-5300
- Fax
- (937) 322-4900
- NPI assigned
- Jan 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LICDC.131087-CS | OH | |
| Professional Counselor | 101YP2500X | C.1700474 | OH | |
| Professional Counselor | 101YP2500X | E.2001748 | OH | Primary |
Addresses
Primary practice location
2624 Lexington Ave
Springfield, OH 45505-2620
Mailing address
2624 Lexington Ave
Springfield, OH 45505-2620
Phone (937) 328-5300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 5, 2024 through Mar 5, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LICDC.131087-CS | OH | MD | Addiction (Substance Use Disorder) Counselor |
| C.1700474 | OH | MD | Professional Counselor |
| E.2001748 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591660800000",
"number": "1558808154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2624 LEXINGTON AVE",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455052620",
"telephone_number": "937-328-5300",
"fax_number": "937-322-4900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2624 LEXINGTON AVE",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455052620",
"telephone_number": "937-328-5300",
"fax_number": "937-322-4900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINSWORTH",
"first_name": "SARAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-21",
"last_updated": "2020-06-09",
"certification_date": "2020-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "LICDC.131087-CS",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "C.1700474",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E.2001748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.