Individual provider Active NPI

Sara Baker, LIMHP, LICSW, LADC

  • Clinical Social Worker
  • Omaha, NE
National Provider Identifier
1629329024
Registry record updated Dec 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1242 Issued in NE
Practice address
4102 Woolworth Ave
Omaha, NE 68105-1851
Phone
(402) 444-4914
Fax
(402) 996-8171
NPI assigned
Sep 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1139 NE
Mental Health Counselor 101YM0800X 1198 NE
Clinical Social Worker 1041C0700X 1242 NE Primary

Addresses

Primary practice location

4102 Woolworth Ave
Omaha, NE 68105-1851

Mailing address

4102 Woolworth Ave
Omaha, NE 68105-1851
Phone (402) 444-4914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20230825002635 NE Practitioner - Clinical Social Worker 8224491097 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1242NEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas County Nebraska CurrentSince Jul 24, 2023 Accepting new patients
Douglas County Nebraska CurrentSince Jul 24, 2023 Accepting new patients

Locations

4102 Woolworth Ave
Omaha, NE 68105
Phone (402) 444-7000

4102 Woolworth Ave
Fl 5
Omaha, NE 68105
Phone (402) 444-7000

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": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483056000000",
    "number": "1629329024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 WOOLWORTH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051851",
            "telephone_number": "402-444-4914",
            "fax_number": "402-996-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 WOOLWORTH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051851",
            "telephone_number": "402-444-4914",
            "fax_number": "402-996-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "SARA",
        "credential": "LIMHP, LICSW, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-25",
        "last_updated": "2016-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "1139",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1198",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "1242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.