Active NPI
Maegen Bernardo, LCSW
- Clinical Social Worker
- Layton, UT
National Provider Identifier
1063294908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 12472382-3501
- Practice address
- 855 Heritage Park Blvd Ste 3
Layton, UT 84041-5732 - Phone
- (801) 447-1015
- Fax
- (801) 447-1035
- NPI assigned
- Oct 16, 2023
- 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 | 12472382-3501 | UT | Primary |
Addresses
Primary practice location
855 Heritage Park Blvd Ste 3
Layton, UT 84041-5732
Mailing address
PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3500
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726099200000",
"number": "1063294908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5546",
"city": "DENVER",
"state": "CO",
"postal_code": "802175546",
"telephone_number": "801-475-3500",
"fax_number": "801-475-3489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 HERITAGE PARK BLVD STE 3",
"city": "LAYTON",
"state": "UT",
"postal_code": "840415732",
"telephone_number": "801-447-1015",
"fax_number": "801-447-1035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNARDO",
"first_name": "MAEGEN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-16",
"last_updated": "2024-09-12",
"certification_date": "2024-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "12472382-3501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Layton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.