Sara Southern, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3814C Issued in AL

Practice address

3801 Blue Pkwy
Kansas City, MO 64130-2807

Phone

(816) 923-5800

NPI assigned

Oct 4, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL, TN2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Serenity Solutions Behavioral Health LLC

  • Clinical Social Worker
  • Huntsville, AL
  • NPI 1396229431
  NPD Authorized official
• Impact Behavioral Counseling LLC

  • Addiction (Substance Use Disorder) Counselor
  • Jackson, TN
  • NPI 1386169050
  Medicare reassignment
• Mental Health Center of North Central Alabama

  • Community/Behavioral Health Agency
  • Decatur, AL
  • NPI 1780859314
  NPD (past)
• Pathway Healthcare-Louisiana, LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Jefferson, LA
  • NPI 1295391837
  NPD (past)

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1689124562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 SOMERVILLE RD SE STE 1",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014309",
            "telephone_number": "256-260-7361",
            "fax_number": "256-350-5664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 BLUE PKWY",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641302807",
            "telephone_number": "816-923-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "295 Hospital St",
            "address_purpose": "LOCATION",
            "city": "Moulton",
            "state": "AL",
            "postal_code": "356501210",
            "country_code": "US",
            "telephone_number": "256-974-6697",
            "fax_number": "256-350-5664",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1307 E Elm St",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "AL",
            "postal_code": "356115318",
            "country_code": "US",
            "telephone_number": "256-232-3661",
            "fax_number": "256-350-5664",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1315 13th Ave SE",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "AL",
            "postal_code": "356014308",
            "country_code": "US",
            "telephone_number": "256-260-7306",
            "fax_number": "256-350-5664",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4110 US Highway 31 S",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "AL",
            "postal_code": "356031644",
            "country_code": "US",
            "telephone_number": "256-260-7360",
            "fax_number": "256-350-5664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUTHERN",
        "first_name": "SARA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "3814C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Allen Soulliere, PLPC
• Daniel Ryan Sounakhen, DC
• Dennis Sourvanos, DDS
• Michelle Sousley
• Lyndsay Deane South, PA, ABA
• Southtown Family Dental LLC
• Southtown Womens Clinic LLC
• James L Southwell Jr., DO
• Southwest Care LLC
• Olayemi Sowemimo, DC

• Clinical Social Worker in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.