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NPI Code Detail

MEDICARE: SARAH SIVERTSEN LCSW

MEDICARE: SARAH SIVERTSEN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker34011778AIN

General Provider Information

NPI Number : 1396381745
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH SIVERTSEN LCSW
Provider Business Mailing Address
First Line : 1575 DR MARTIN LUTHER KING JR ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2295
Country : US
Telephone Number : 317-644-7243
Fax Number :
Provider Business Practice Location Address
First Line : 2240 N MERIDIAN ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46208-5728
Country : US
Telephone Number : 317-908-9351
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2019
Last Update Date : 03/07/2025

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Directions to “ SARAH SIVERTSEN LCSW” Practice Location

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