SALLY ANN PRIMUS (NPI# 1225228828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225228828 |
| Entity Type | Individual |
| Full Name | SALLY ANN PRIMUS |
| Credential | MSW, LCSW |
| Practice Address |
3176 Lancer St Suite 501 Portage IN 46368 |
| Mailing Address |
3176 Lancer St Portage IN 46368 |
| Practice Telephone | 2197629557 |
| Practice Fax Number | 2197627318 |
| Mailing Telephone | 2197629557 |
| Mailing Fax Number | 2197627318 |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2011-07-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
34006144A | IN | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
99027928A | IN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 10016380A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114292208 | Sally G Primus | Ophthalmology | 1020 W Buena Vista Rd, Evansville, IN 47710-5150 | 2012-03-21 |
| Street Address |
3176 LANCER ST SUITE 501 |
| City | PORTAGE |
| State | IN |
| Zip Code | 46368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205968385 | Lisette Haro | Social Worker | 3176 Lancer St, Portage, IN 46368-4408 | 2007-03-12 |
| 1306118468 | Mario Lara | Counselor | 3176 Lancer St, Portage, IN 46368-4408 | 2012-02-06 |
| 1023380276 | Michael Imburgia | Counselor | 3176 Lancer St, Portage, IN 46368-4408 | 2012-02-03 |
| 1194009035 | Elise D Daxe | Social Worker | 3176 Lancer St, Portage, IN 46368-4408 | 2011-10-10 |
| 1104109222 | Karen C. Schimpf | Counselor | 3176 Lancer St, Portage, IN 46368-4408 | 2011-09-25 |
| 1811223407 | David Allen Johnson | Counselor | 3176 Lancer St, Portage, IN 46368-4408 | 2009-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1831576693 | Bishara Robert Khoury | Family Medicine | 3545 Arbor Blvd Ste E, Portage, IN 46368 | 2015-04-30 |
| 1962813535 | Diane Farrington | Pharmacist | 6050 Us Hwy 6, Portage, IN 46368 | 2014-05-16 |
| 1588827562 | Jennifer Ann Rumpel | Allergy & Immunology | 6375 Us Highway 6 Ste C, Portage, IN 46368 | 2008-07-09 |
| 1588822688 | Total Renal Care Inc | Clinic/Center | 5823 Us Highway 6, Portage, IN 46368 | 2008-05-27 |
| 1235321480 | Michael Wendahl | Physical Therapist | 3691 Willowcreek Road, Suite 100, Portage, IN 46368 | 2007-08-13 |
| 1679663603 | Stephen V Headley | Family Medicine | 3283 Willowcreek Rd, Portage, IN 46368 | 2006-10-13 |
| 1730276486 | Robert Tan Ang | Psychiatry & Neurology | 3156 Willowcreek Road, Portage, IN 46368 | 2006-10-06 |
| 1013029883 | Primary Care PC | Family Medicine | 3125 Willowcreek Road, Portage, IN 46368 | 2006-08-31 |
| 1104936962 | Margaret Eileen Griffith | Dentist | 2646 Lois Street, Portage, IN 46368 | 2006-08-30 |
| Find all providers in zip 46368 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| 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. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902431380 | Lori E King | Social Worker | 111 E Mullett St, Portage, WI 53901-2325 | 2020-03-06 |
| 1508414368 | Kylie Marie Bader | Social Worker | 614 Romence Rd Ste 245, Portage, MI 49024-3613 | 2019-08-26 |
| 1922651041 | Matthew Jackson | Social Worker | 1820 Pleasant Dr, Portage, MI 49002-5604 | 2019-07-17 |
| 1770044265 | Marie Jeanette Brown | Social Worker | 10784 Schuur St, Portage, MI 49024-7732 | 2019-03-27 |
| 1699249557 | Angela Gutierrez | Social Worker | 2428 Sea Horse St, Portage, IN 46368-6509 | 2019-01-14 |
| 1093288680 | Connected Counseling LLC | Social Worker | 1591 W Centre Ave Ste 103, Portage, MI 49024-5342 | 2019-01-07 |
| 1164925269 | Joy Unlimited Counseling Center, Plc | Social Worker | 6100 Newport Rd Ste 222a, Portage, MI 49002-9235 | 2018-03-14 |
| 1316340029 | Rebecca Clore | Social Worker | 6412 Hampton St, Portage, MI 49024-2532 | 2014-10-08 |
| 1417395393 | Barbara Joanne O'rourke | Social Worker | 721 W Centre Ave, Portage, MI 49024-5309 | 2013-06-12 |
| 1952654162 | Kristin Ranum | Social Worker | 322 Dewitt St, Portage, WI 53901-2114 | 2012-10-25 |
| Find all providers in PORTAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.