Active NPI
Elisabeth Constance Saucedo
- Clinical Social Worker
- Roy, UT
National Provider Identifier
1013414408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 9753119-3501
- Practice address
- 4655 S 1900 W
Roy, UT 84067-2772 - Phone
- (385) 456-5778
- Fax
- (801) 797-0252
- NPI assigned
- Apr 11, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 9753119-3501 | UT | Primary |
| Clinical Social Worker | 1041C0700X | |||
| Counselor | 101Y00000X | |||
| Counselor | 101Y00000X | UT |
Addresses
Primary practice location
4655 S 1900 W
Roy, UT 84067-2772
Mailing address
4655 S 1900 W Ste 5
Roy, UT 84067-2773
Phone (385) 456-5778
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000055266 | Other | UT | MEDICARE PIN |
| 260022408 | Other | UT | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9753119-3501 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755043200000",
"number": "1013414408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4655 S 1900 W STE 5",
"city": "ROY",
"state": "UT",
"postal_code": "840672773",
"telephone_number": "385-456-5778",
"fax_number": "801-797-0252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4655 S 1900 W",
"city": "ROY",
"state": "UT",
"postal_code": "840672772",
"telephone_number": "385-456-5778",
"fax_number": "801-797-0252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAUCEDO",
"first_name": "ELISABETH",
"middle_name": "CONSTANCE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-11",
"last_updated": "2025-08-13",
"certification_date": "2025-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "9753119-3501",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "UT",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PIN",
"identifier": "000055266",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "260022408",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.