Millcreek Therapy Psychological Services

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MILLCREEK THERAPY PSYCHOLOGICAL SERVICES

Doing business as

Millcreek Therapy Psychological Services

Practice address

1398 E Luck LN
Millcreek, UT 84106-2944

Phone

(801) 870-3716

NPI assigned

Mar 20, 2023

Last updated

Oct 17, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nancy Kimmerly, LCSWNPI 1548752264

Title

Owner / LCSW

Phone

(801) 870-3716

Specialties & licenses 1

Addresses

Other names 1

• Millcreek Therapy Psychological Services Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nancy Kimmerly, PHD, CSW

  • Clinical Social Worker
  • Salt Lake City, UT
  • NPI 1548752264
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1033811401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1398 E LUCK LN",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841062944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1398 E LUCK LN",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841062944",
            "telephone_number": "801-870-3716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLCREEK THERAPY PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "KIMMERLY",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "OWNER / LCSW",
        "authorized_official_telephone_number": "801-870-3716",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Millcreek Therapy Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Millcreek Therapy Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyleigh Mickolick
• Nicole Lenore Mihalopoulos, MD
• Millcreek Haven, LLC (The Haven at Millcreek)
• Millcreek Mind and Wellness
• Millcreek PDC PLLC (Reason to Smile Dental)
• Alec Miller, MA
• Kaitlyn Miner, RBT
• Adam M Montgomery, CPSS
• Cristel Moreno, RBT
• Claire Keri Morgan, RBT

• Clinical Social Worker in Millcreek, UT
• Providers in Millcreek, 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 Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.