SARA N JETTAWI LPC
NPI 1447912480
Counselor in Kenosha, WI

Q: What is Sara Jettawi's NPI number?

The NPI number for Sara Jettawi is 1447912480. It was assigned to this individual provider in the NPPES registry on October 7, 2021. The provider is also known as Sara Salzman Lpc.

Q: What is Sara Jettawi's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Sara Jettawi was last updated on June 4, 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.

Active since October 07, 2021PECOS Enrolled

2108 63RD ST, KENOSHA, WI 53143(262) 652-2406 Get Directions Write a Review

NPPES record last updated: June 4, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 4, 2024, Jun 9, 2023, Oct 7, 2021 (3 updates tracked since 2021).

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About Sara N Jettawi Lpc NPPES

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

SARA N JETTAWI LPC (NPI 1447912480) is an individual counselor in Kenosha, Wisconsin, licensed in Wisconsin (10456-125) and active in the NPI registry since October 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1447912480

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameSARA N JETTAWICredential: LPC

Location Address2108 63RD STKenosha, WI 53143-4454

Mailing Address6233 39th AveKenosha, WI 53142-7015 · (262) 654-1004

Phone(262) 652-2406

Sole ProprietorNo

Enumeration DateOctober 7, 2021

Last NPPES UpdateJune 4, 20243 updates tracked since enumeration

NPPES CertifiedJune 4, 2024

✔ NPI 1447912480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

License✔ Licensed in WI · 10456-125

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 10456-125 (WI)

Also ListedSocial WorkerTaxonomy 104100000X · License 5035-226 (WI)

2108 63RD ST, Kenosha, WI 53143

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Other Names 1

Former Name (1)Sara Salzman Lpc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Medica and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sara N Jettawi Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA MARTZAHL LPC

Counselor (Professional)