Individual provider Active NPI

Sarena Clubb, LMSW

  • Social Worker
  • Wichita, KS
National Provider Identifier
1639550940
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
9560 Issued in KS
Practice address
350 S Broadway St
Wichita, KS 67202-4304
Phone
(316) 660-9600
Fax
(316) 660-9669
NPI assigned
Jun 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 9560 KS Primary

Addresses

Primary practice location

350 S Broadway St
Wichita, KS 67202-4304

Mailing address

635 N Main St
Wichita, KS 67203-3602
Phone (316) 660-7600

Other names 1

  • Sarena Maier Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9560KSMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1639550940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 N MAIN ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672033602",
            "telephone_number": "316-660-7600",
            "fax_number": "316-941-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S BROADWAY ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672024304",
            "telephone_number": "316-660-9600",
            "fax_number": "316-660-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUBB",
        "first_name": "SARENA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "9560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARENA",
            "last_name": "MAIER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.