Individual provider Active NPI

Sarah A Phillips, LCSW, CSAC

  • Clinical Social Worker
  • De Pere, WI
National Provider Identifier
1649616764
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8476-123 Issued in WI
Practice address
1325 Angels Path
De Pere, WI 54115-4050
Phone
(920) 338-2855
Fax
(920) 338-9270
NPI assigned
May 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 16128-132 WI
Addiction (Substance Use Disorder) Counselor 101YA0400X 16778-130 WI
Social Worker 104100000X 128960-121 WI
Clinical Social Worker 1041C0700X 8476-123 WI Primary

Addresses

Primary practice location

1325 Angels Path
De Pere, WI 54115-4050

Mailing address

PO Box 22040
Green Bay, WI 54305-2040
Phone (920) 445-7222

Other practice location 1

424 S Monroe Ave
Suite 201
Green Bay, WI 54301-4054
Phone (920) 445-0170

Other names 1

  • Sarah A Novitski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20210831003776 WI Practitioner - Clinical Social Worker 6406252394 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

1325 Angels Path
De Pere, WI 54115-4050
Phone (920) 338-2855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16778-130WIMDAddiction (Substance Use Disorder) Counselor
128960-121WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince May 19, 2025 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Psychiatric Center Inc CurrentSince Aug 16, 2021 Accepting new patients
Bellin Memorial Hospital Inc Clinical CurrentSince May 19, 2025 Accepting new patients
Bellin Psychiatric Center Inc. Clinical CurrentSince Aug 16, 2021 Accepting new patients

Locations

1325 Angels Path
De Pere, WI 54115
Phone (920) 338-2855

704 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-3784

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

301 Saint Joseph St
Green Bay, WI 54301
Phone (920) 430-3630

Organizations & group practices 5

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": "1368576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1649616764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22040",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052040",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 ANGELS PATH",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541154050",
            "telephone_number": "920-338-2855",
            "fax_number": "920-338-9270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "424 S Monroe Ave",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543014054",
            "country_code": "US",
            "telephone_number": "920-445-0170",
            "fax_number": "920-445-0174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SARAH",
        "middle_name": "A",
        "credential": "LCSW, CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-15",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16128-132",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16778-130",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "128960-121",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8476-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "NOVITSKI",
            "middle_name": "A",
            "credential": "LCSW,CSAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in De Pere, WI

Sources for this page

Verify at the official NPI Registry.