Individual provider Active NPI

Glen Ray Lambert, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1003021346
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
109658-3501 Issued in UT
Practice address
1361 Rebecca Cir
Salt Lake City, UT 84117-5864
Phone
(801) 272-7742
Fax
(801) 322-2831
NPI assigned
May 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 109658-3501 UT Primary

Addresses

Primary practice location

1361 Rebecca Cir
Salt Lake City, UT 84117-5864

Mailing address

1361 Rebecca Cir
Salt Lake City, UT 84117-5864
Phone (801) 272-7742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
109658-3501UTMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003021346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 REBECCA CIR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841175864",
            "telephone_number": "801-272-7742",
            "fax_number": "801-322-2831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 REBECCA CIR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841175864",
            "telephone_number": "801-272-7742",
            "fax_number": "801-322-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBERT",
        "first_name": "GLEN",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "109658-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.