Individual provider Active NPI

Sara Beth Johnson, M.S.W., L.C.S.W, PHD

  • Clinical Social Worker
  • Oak Park, IL
National Provider Identifier
1750598728
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149009492 Issued in IL
Practice address
1010 Lake St Ste 500
Oak Park, IL 60301-1135
Phone
(773) 665-8052
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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 149009492 IL Primary

Addresses

Primary practice location

1010 Lake St Ste 500
Oak Park, IL 60301-1135

Mailing address

610 S Maple Ave
Suite 5300
Oak Park, IL 60304-1091
Phone (708) 660-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20110329000920 IL Practitioner - Clinical Social Worker 5890978803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Smart Love Parenting CenterGroup PAC ID 8729261011, 11 clinicians

Practice addresses (Care Compare)

1010 Lake St
Oak Park, IL 60301-1135
Phone (773) 665-8052

800 W Buena Ave
Chicago, IL 60613-6230
Phone (773) 665-8052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Smart Love Parenting Center CurrentSince Mar 15, 2024 Accepting new patients

Locations

800 W Buena Ave
Chicago, IL 60613
Phone (773) 327-6000

1010 Lake St
Ste 500
Oak Park, IL 60301
Phone (708) 524-8600

610 S Maple Ave
Ste 5300
Oak Park, IL 60304
Phone (708) 660-2350

Organizations & group practices 1

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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1750598728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S MAPLE AVE",
            "address_2": "SUITE 5300",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041091",
            "telephone_number": "708-660-4300",
            "fax_number": "708-660-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST STE 500",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011135",
            "telephone_number": "773-665-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SARA",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "M.S.W., L.C.S.W, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149009492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.