Individual provider Active NPI

Sandra Risch, LISW

  • Clinical Social Worker
  • Davenport, IA
National Provider Identifier
1801806260
Registry record updated Jun 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
01064 Issued in IA
Practice address
2028 E 38TH St Ste 3
Davenport, IA 52807-1168
Phone
(563) 424-2016
Fax
(563) 424-2017
NPI assigned
Aug 8, 2006
Last updated
Jun 30, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2013

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 01064 IA Primary

Addresses

Primary practice location

2028 E 38TH St Ste 3
Davenport, IA 52807-1168

Mailing address

2028 E 38TH St Ste 3
Davenport, IA 52807-1168
Phone (563) 424-2016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20130613000446 IA Practitioner - Clinical Social Worker 0648463992 Reassigns benefits to 1 organization
Practice locations: Davenport, IA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
QC Counselor PLCGroup PAC ID 9537510730, 4 clinicians

Practice addresses (Care Compare)

2028 E 38TH St
Suite 3
Davenport, IA 52807-1168
Phone (563) 424-2016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01064IAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
QC Counselor PLC CurrentSince Mar 31, 2024 Accepting new patients
Southpark Psychology LTD Clinical PastSince Jan 1, 2013 Accepting new patients
Qccounselor PastSince Mar 31, 2024 Accepting new patients

Locations

2028 E 38th St
Ste 3
Davenport, IA 52807
Phone (563) 424-2016

Organizations & group practices 3

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372550400000",
    "number": "1801806260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 E 38TH ST STE 3",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071168",
            "telephone_number": "563-424-2016",
            "fax_number": "563-424-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2028 E 38TH ST STE 3",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071168",
            "telephone_number": "563-424-2016",
            "fax_number": "563-424-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISCH",
        "first_name": "SANDRA",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2013-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "01064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.