SARA SOUTHERN LICSW
NPI 1689124562
Social Worker - Clinical in Kansas City, MO

Q: What is Sara Southern's NPI number?

The NPI number for Sara Southern is 1689124562. It was assigned to this individual provider in the NPPES registry on October 4, 2016.

Q: What is Sara Southern's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Sara Southern was last updated on July 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 04, 2016PECOS Enrolled

3801 BLUE PKWY, KANSAS CITY, MO 64130(816) 923-5800 Get Directions Write a Review

NPPES record last updated: July 28, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 28, 2021, Mar 17, 2018, Nov 27, 2017 (3 updates tracked since 2017).

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About Sara Southern Licsw NPPES

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

SARA SOUTHERN LICSW (NPI 1689124562) is an individual clinical provider in Kansas City, Missouri, licensed in Alabama (3814C) and active in the NPI registry since October 2016. She is enrolled in Medicare PECOS and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1689124562

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameSARA SOUTHERNCredential: LICSW

Location Address3801 BLUE PKWYKansas City, MO 64130-2807

Mailing Address1316 Somerville Rd Se Ste 1Decatur, AL 35601-4309 · (256) 260-7361 · Fax (256) 350-5664

Phone(816) 923-5800

Sole ProprietorNo

Enumeration DateOctober 4, 2016

Last NPPES UpdateJuly 28, 20213 updates tracked since enumeration

NPPES CertifiedJuly 28, 2021

✔ NPI 1689124562 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in AL · 3814C

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

3801 BLUE PKWY, Kansas City, MO 64130

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Secondary Practice Locations 4

Location 1295 Hospital StMoulton, AL 35650-1210 · Phone (256) 974-6697 · Fax (256) 350-5664

Location 21307 E Elm StAthens, AL 35611-5318 · Phone (256) 232-3661 · Fax (256) 350-5664

Location 31315 13th Ave SEDecatur, AL 35601-4308 · Phone (256) 260-7306 · Fax (256) 350-5664

Location 44110 US Highway 31 SDecatur, AL 35603-1644 · Phone (256) 260-7360 · Fax (256) 350-5664

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sara Southern Licsw 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.

Medicare Billing Reassignment

Medicare enrollment records show Sara Southern reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Impact Behavioral Counseling LLC

389 mi

Addiction (Substance Use Disorder)

37 SANDSTONE CIR STE 92B
Jackson, TN 38305

Reassigned Medicare billing, Tennessee enrollment
14 clinicians in this Medicare group

NPI 1386169050 (731) 265-6025

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 30 minutes 90832

Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 30-minute session, the therapist helps you explore feelings, thoughts, and behaviors to better understand yourself and manage life's challenges.

49 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 64130 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $55.29 – $168.52

Typical copayment $0.00 (range $13.82 – $42.13)

Most-billed visit code NA

Established Patient

$69.10 typical visit price

range $17.60 – $137.20

Typical copayment $17.27 (range $4.40 – $34.30)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

SEAN M RYAN FNP-C

Nurse Practitioner (Family)