Individual provider Active NPI

Sarah Elizabeth Gibson, LCSW

  • Clinical Social Worker
  • Granite City, IL
National Provider Identifier
1982189650
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.019999 Issued in IL
Practice address
50 Northgate Industrial Dr
Granite City, IL 62040-6805
Phone
(618) 877-4420
NPI assigned
Sep 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 149.019999 IL Primary

Addresses

Primary practice location

50 Northgate Industrial Dr
Granite City, IL 62040-6805

Mailing address

50 Northgate Industrial Dr
Granite City, IL 62040-6805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • 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
I20181022003035 IL Practitioner - Clinical Social Worker 3072866037 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.019999ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chestnut Health Systems Inc CurrentSince Oct 1, 2018 Accepting new patients
Sarah Gibson Counseling, LLC Clinical Current Accepting new patients
Chestnut Health Systems Inc. CurrentSince Oct 1, 2018 Accepting new patients

Locations

1003 Martin Luther King Dr
Bloomington, IL 61701
Phone (309) 827-6026

50 Northgate Industrial Dr
Granite City, IL 62040
Phone (618) 512-1919

2148 Vadalabene Dr
Maryville, IL 62062
Phone (618) 288-3100

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": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1982189650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 NORTHGATE INDUSTRIAL DR",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620406805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 NORTHGATE INDUSTRIAL DR",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620406805",
            "telephone_number": "618-877-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.019999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite City, IL

Sources for this page

Verify at the official NPI Registry.