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SANDRA DAVIS CHISHOLM LCSW
NPI 1356538219
Social Worker in Coopersburg, PA

Active since September 25, 2007Opted out of Medicare · through Apr 1, 2028
6185 WHITETAIL DR, COOPERSBURG, PA 18036(610) 745-9136 Get Directions Write a Review

NPPES record last updated: February 13, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sandra Davis Chisholm Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SANDRA DAVIS CHISHOLM LCSW (NPI 1356538219) is an individual social worker in Coopersburg, Pennsylvania, licensed in New York (077669) and active in the NPI registry since September 2007. She has opted out of Medicare through April 1, 2028 and maintains a secondary practice location in Bethlehem.

NPPES Registry Identity

NPI1356538219
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameSANDRA DAVIS CHISHOLMCredential: LCSW
Location Address6185 WHITETAIL DRCoopersburg, PA 18036-9581
Mailing Address6185 Whitetail DrCoopersburg, PA 18036-9581 · (610) 745-9136
Phone(610) 745-9136
Sole ProprietorYes
Enumeration DateSeptember 25, 2007
Last NPPES UpdateFebruary 13, 2024
NPPES CertifiedFebruary 13, 2024
✔ NPI 1356538219 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in NY · 077669
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 017925 (PA)
6185 WHITETAIL DR, Coopersburg, PA 18036
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Secondary Practice Location 1

Location 1807 W Broad StBethlehem, PA 18018-5223 · Phone (610) 745-9136

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Sandra Davis Chisholm Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2024 through April 1, 2028.

Opt-Out Effective DateApril 1, 2024
Opt-Out In Effect ThroughApril 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sandra Chisholm's NPI number?

The NPI number for Sandra Chisholm is 1356538219. It was assigned to this individual provider in the NPPES registry on September 25, 2007.

Where is Sandra Chisholm located?

Sandra Chisholm practices at 6185 Whitetail Dr, Coopersburg, PA 18036. The listed phone number is (610) 745-9136.

What is Sandra Chisholm's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Sandra Chisholm enrolled in Medicare?

No. Sandra Chisholm has opted out of Medicare through April 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Sandra Chisholm was last updated on February 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.