Active NPI
Delrea B Lilligridge, SSW
- Clinical Social Worker
- Moab, UT
National Provider Identifier
1053485219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 48735623503
- Practice address
- 198 East Center Street
Moab, UT 84532 - Phone
- (435) 259-6131
- Fax
- (435) 259-5369
- NPI assigned
- Nov 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 48735623503 | UT | Primary |
Addresses
Primary practice location
198 East Center Street
Moab, UT 84532
Mailing address
PO Box 867
Price, UT 84501
Phone (435) 637-7200
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
| License | State | Type | Specialty |
|---|---|---|---|
| 48735623503 | UT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Four Corners Community Behavioral Health, Inc. | Past | Accepting new patients | |
| Four Corners Community Behavioral Health Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Methadone Clinic
- Price, UT
- NPI 1164048492
-
- Community/Behavioral Health Agency
- Price, UT
- NPI 1487715330
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053485219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 867",
"city": "PRICE",
"state": "UT",
"postal_code": "84501",
"telephone_number": "435-637-7200",
"fax_number": "435-637-2377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "198 EAST CENTER STREET",
"city": "MOAB",
"state": "UT",
"postal_code": "84532",
"telephone_number": "435-259-6131",
"fax_number": "435-259-5369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILLIGRIDGE",
"first_name": "DELREA",
"middle_name": "B",
"credential": "SSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "48735623503",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moab, 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.