Individual provider Active NPI

Sarah Bienvenu, LCSW

  • Clinical Social Worker
  • Moselle, MS
National Provider Identifier
1679297170
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C7996 Issued in MS
Practice address
3 Clearview Cir
Moselle, MS 39459-9520
Phone
(601) 544-1499
NPI assigned
Sep 28, 2022
Last updated
Sep 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C7996 MS Primary

Addresses

Primary practice location

3 Clearview Cir
Moselle, MS 39459-9520

Mailing address

PO Box 18679
Hattiesburg, MS 39404-8679
Phone (601) 705-1901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: No
  • 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
I20231103001602 MS Practitioner - Clinical Social Worker 0648627281 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Harbor Clinic LLC CurrentSince Oct 31, 2023 Accepting new patients
Region 12 Commission on Mental Health and Retardation PastSince Oct 2, 2022 Accepting new patients

Locations

4011 Beatline Rd
Ste 7
Long Beach, MS 39560
Phone (228) 200-0720

4013 Beatline Rd
#A
Long Beach, MS 39560
Phone (228) 200-0720

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1679297170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18679",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394048679",
            "telephone_number": "601-705-1901",
            "fax_number": "601-705-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CLEARVIEW CIR",
            "city": "MOSELLE",
            "state": "MS",
            "postal_code": "394599520",
            "telephone_number": "601-544-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIENVENU",
        "first_name": "SARAH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C7996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moselle, MS

Sources for this page

Verify at the official NPI Registry.