Jessica Chang
Individual provider Active NPI Clinical Social Worker · Center, UT
NPI 1013529932 · NPPES record last updated Aug 21, 2020
Key facts
- NPI
- 1013529932
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6679223-3501 (UT)
- Practice address
- 870 W
Center, UT 84057 - Phone
- (435) 773-7339
- NPI assigned
- Aug 21, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6679223-3501 | UT | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6679223-3501 | UT | Yes |
Addresses
Primary practice location
870 W
Center, UT 84057
Mailing address
60 E 400 N
Springville, UT 84663
Phone (435) 773-7339
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.