Melanie Richardson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

117243-3501 Issued in UT

Practice address

1188 W Sportsplex Dr Ste 203
Kaysville, UT 84037-6817

Phone

(801) 719-7737

Fax

(888) 887-9784

NPI assigned

May 12, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in ID, UT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psychological Preventative Health PLLCGroup PAC ID 8820414600, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psychological Preventative Health PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Idaho Falls, ID
  • NPI 1649808767

  UT

  Medicare reassignment Care Compare group NPD
• Ash & Ascent Therapy

  • Social Worker
  • Ogden, UT
  • NPI 1639014624
  NPD (past)
• Empowering Relief Counseling, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Murray, UT
  • NPI 1548796931

  Social Worker

  NPD (past)

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1013328103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2184 CHANNING WAY # 157",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048034",
            "telephone_number": "801-719-7737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 W SPORTSPLEX DR STE 203",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840376817",
            "telephone_number": "801-719-7737",
            "fax_number": "888-887-9784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 N Yellowstone Hwy Ste 207",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834011652",
            "country_code": "US",
            "telephone_number": "801-719-7737",
            "fax_number": "888-887-9784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4933 S 1500 W",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "UT",
            "postal_code": "844057175",
            "country_code": "US",
            "telephone_number": "801-719-7737",
            "fax_number": "888-887-9784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2317 N Hill Field Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840414782",
            "country_code": "US",
            "telephone_number": "801-719-7737",
            "fax_number": "888-887-9784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4933 S 1500 W",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "UT",
            "postal_code": "84405",
            "country_code": "US",
            "telephone_number": "801-719-7737",
            "fax_number": "888-887-9784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2363 N Hill Field Rd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840416958",
            "country_code": "US",
            "telephone_number": "801-719-7737",
            "fax_number": "888-887-9784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "MELANIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-12",
        "last_updated": "2022-02-23",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCSW-36133",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-33744",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-36133",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "117243-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Restoration Physical Therapy LLC
• Airyn Reyes
• Emily Martineau Rich
• Kori Dee Richards, FNP-C
• Jared Richardson, DMD
• Heather Gayle Rimington, APRN-PMHNP-BC
• Ken A Rivas, D.C.
• Dylan Norberto Rodriguez, PT, DPT
• Roe RX Inc
• Cortney Roper, LAT, ATC

• Clinical Social Worker in Kaysville, UT
• Providers in Kaysville, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.