Paul Sexton, LCSW
NPI 1265914428 · Clinical Social Worker · South Bend, IN
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Paul Sexton, LCSW is a Clinical Social Worker provider in South Bend, IN (NPI 1265914428).
Provider details
- NPI number
- 1265914428
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- Yes
- License
- 131117 (WI)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
- Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
7 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
57 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Psychotherapy, 30 Minutes90832 | 41 | $56 |
| Psychiatric Diagnostic Evaluation90791 | 16 | $123 |
Typical Medicare-allowed amounts for these services range $56–$123 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Registry dates
- Enumerated
- 2018-09-04
- Last updated
- 2021-08-06
- Certified
- 2021-08-06
Frequently asked questions
- What is Paul Sexton's NPI number?
- Paul Sexton's National Provider Identifier (NPI) is 1265914428, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Paul Sexton's specialty?
- Paul Sexton is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Paul Sexton located?
- Paul Sexton's practice location on file with NPPES is 621 Memorial Dr Ste 402, South Bend, IN 46601-1074.
- What is Paul Sexton's phone number?
- The practice phone number listed in the NPPES registry for Paul Sexton is (574) 280-8199.
- Does Paul Sexton accept Medicare?
- Paul Sexton is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Paul Sexton's NPI active?
- Yes — Paul Sexton's NPI (1265914428) is active in the NPPES registry as of the last update on 2021-08-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.