NPIMap

Individual provider Active NPI

Sasha Waller Reardon, LCSW

  • Clinical Social Worker
  • Carmel, IN
National Provider Identifier
1962077628
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34009294A Issued in IN
Practice address
1185 W Carmel Dr Ste D4
Carmel, IN 46032-8708
Phone
(317) 569-5433
Fax
(317) 569-1767
NPI assigned
May 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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 34009294A IN Primary

Addresses

Primary practice location

1185 W Carmel Dr Ste D4
Carmel, IN 46032-8708

Mailing address

1185 W Carmel Dr Ste D4
Carmel, IN 46032-8708
Phone (317) 569-5433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210910000145 IN Practitioner - Clinical Social Worker 6901202399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Behavioral Care of Colorado PC 196 clinicians

Practice addresses (Care Compare)

1185 W Carmel Dr
Suite D4
Carmel, IN 46032-8708
Phone (317) 569-5433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Apr 1, 2024 Accepting new patients
Optum Behavioral Care of Colorado, P.C. Clinical CurrentSince Apr 1, 2024 Accepting new patients

Locations

1185 W Carmel Dr
Ste D4
Carmel, IN 46032
Phone (317) 208-2300

Interoperability endpoints

  • Direct secure messaging: sasha.reardon.1@28621.direct.athenahealth.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1962077628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 W CARMEL DR STE D4",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328708",
            "telephone_number": "317-569-5433",
            "fax_number": "317-569-1767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 W CARMEL DR STE D4",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328708",
            "telephone_number": "317-569-5433",
            "fax_number": "317-569-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDON",
        "first_name": "SASHA",
        "middle_name": "WALLER",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009294A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.