Individual provider Active NPI

Stephanie Diane Lowe Burry, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1710059779
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34005082A Issued in IN
Practice address
8935 N Meridian St Ste 225
Indianapolis, IN 46260-5384
Phone
(317) 439-7618
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 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 34005082A IN Primary

Addresses

Primary practice location

8935 N Meridian St Ste 225
Indianapolis, IN 46260-5384

Mailing address

5708 Winthrop Ave
Indianapolis, IN 46220-2630
Phone (173) 439-7618

Other identifiers 3

IdentifierTypeStateIssuer
201178980AMedicaidIN
201163980MedicaidIN
IN1231OtherINMEDICARE GROUP

Other names 1

  • Stephanie Diane Lowe Sagebiel Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL INDIANAPOLIS Direct

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
34005082AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Baume Psychological Services, P.C. CurrentSince Apr 29, 2013 Accepting new patients
Emerald Neuro-Recover PastSince Feb 11, 2020 Accepting new patients

Locations

12265 Hancock St
Ste 42
Carmel, IN 46032
Phone (317) 606-8778

12337 Hancock St
Ste 20
Carmel, IN 46032
Phone (317) 706-6744

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1710059779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5708 WINTHROP AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462202630",
            "telephone_number": "173-439-7618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8935 N MERIDIAN ST STE 225",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605384",
            "telephone_number": "317-439-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWE BURRY",
        "first_name": "STEPHANIE",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005082A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201178980A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201163980",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "IN1231",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "INDIANAPOLIS",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8935 N Meridian St Ste 225",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462605384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "LOWE SAGEBIEL",
            "middle_name": "DIANE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.