SARAH JANE PETERSEN (LCSW) – Social Worker, NPI 1073228607

SARAH JANE PETERSEN (LCSW) is a healthcare provider. based in Beloit, Wisconsin. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. The NPI Number for SARAH JANE PETERSEN (LCSW) is 1073228607

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
SARAH JANE PETERSEN (LCSW)
NPI
1073228607
Phone
(608) 368-8087
Address
540 E GRAND AVE
Enumeration Date
18 January 2023
Last Update Date
1 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6083688087
Graduation Year
2019 (7 years ago)
PAC ID
7719337542
Group Practice PAC ID
1658655865
Professional Enrollment ID
I20231220001260
Address ID
WI535116314BE540XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:3State licenses:0Digital endpointsOther names

1,482 CLINICAL SOCIAL WORKER in WI

Provider Addresses for SARAH JANE PETERSEN (LCSW)

  • 540 E GRAND AVE

    BELOIT, WI 535116314

    Phone: (608) 368-8087

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-12-20

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231220001260IClinical Social WorkerWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 53511)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1658655865View full group profile
NameSpecialtyState
Nurse PractitionerWI
Mental Health CounselorWI
Clinical Social WorkerWI
Clinical Social WorkerWI
Clinical Social WorkerWI
Mental Health CounselorWI
Clinical Social WorkerWI
Clinical Social WorkerWI
Clinical Social WorkerWI
Mental Health CounselorWI

Reviews

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Frequently asked questions

Can I use this page to confirm SARAH JANE PETERSEN (LCSW)'s NPI?
Yes. SARAH JANE PETERSEN (LCSW) is listed with NPI 1073228607 in the public NPI dataset.
Does the file indicate SARAH JANE PETERSEN (LCSW) is practicing under active NPI?
Directory data currently reports SARAH JANE PETERSEN (LCSW) as active.
What taxonomy line describes SARAH JANE PETERSEN (LCSW)?
For research purposes, treat SARAH JANE PETERSEN (LCSW) as Social Worker in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for SARAH JANE PETERSEN (LCSW)?
SARAH JANE PETERSEN (LCSW)'s geographic hint is Beloit, Wisconsin in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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