Individual provider Active NPI

Karin G Douthit, LCSW

  • Clinical Social Worker
  • Roosevelt, UT
National Provider Identifier
1063595288
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
364057-3501 Issued in UT
Practice address
285 W 800 S
Roosevelt, UT 84066-3707
Phone
(435) 725-6300
Fax
(435) 725-6325
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 364057-3501 UT Primary

Addresses

Primary practice location

285 W 800 S
Roosevelt, UT 84066-3707

Mailing address

631 Areva Rd # 68-9
Roosevelt, UT 84066-2209
Phone (435) 725-6300

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
364057-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Uintah Basin Tri-County Mental Health and Substance Abuse Local Author Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063595288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 AREVA RD # 68-9",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840662209",
            "telephone_number": "435-725-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 W 800 S",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840663707",
            "telephone_number": "435-725-6300",
            "fax_number": "435-725-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUTHIT",
        "first_name": "KARIN",
        "middle_name": "G",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "364057-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roosevelt, 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.

Verify at the official NPI Registry.