Individual provider Active NPI

Sarah A Von Der Mehden, LCSW

  • Clinical Social Worker
  • Kokomo, IN
National Provider Identifier
1902209984
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007028A Issued in IN
Practice address
424 E Southway Blvd Ste 1
Kokomo, IN 46902-3814
Phone
(765) 865-8914
NPI assigned
Oct 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 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 34007028A IN Primary

Addresses

Primary practice location

424 E Southway Blvd Ste 1
Kokomo, IN 46902-3814

Mailing address

240 N Tillotson Ave
Muncie, IN 47304-3988

Other names 1

  • Sarah A Tezich Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20210820000864 IN Practitioner - Clinical Social Worker 3577968122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meridian Health Services CorpGroup PAC ID 5597679845, 78 clinicians

Practice addresses (Care Compare)

424 E Southway Blvd
Kokomo, IN 46902-3814
Phone (765) 288-1928

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34007028AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Health Services Corp. CurrentSince Sep 22, 2024 Accepting new patients
Meridian Health Services Corp. CurrentSince May 12, 2024 Accepting new patients
Meridian Health Services Corp CurrentSince Sep 22, 2024 Accepting new patients
Northern Indiana Therapies Past Accepting new patients

Locations

424 E Southway Blvd
Ste 1
Kokomo, IN 46902
Phone (765) 865-8914

424 E Southway Blvd
Kokomo, IN 46902
Phone (765) 480-9184

240 N Tillotson Ave
Muncie, IN 47304

Interoperability endpoints

  • Direct secure messaging: sarah.vondermehden.p1@direct.meridianhs.nextgenshare.com

Organizations & group practices 4

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": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1902209984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "fax_number": "765-288-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 E SOUTHWAY BLVD STE 1",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023814",
            "telephone_number": "765-865-8914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON DER MEHDEN",
        "first_name": "SARAH",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-03",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007028A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "TEZICH",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.