Active NPI
Eric Poulsen Watts, CSW
- Social Worker
- Salt Lake City, UT
National Provider Identifier
1063730380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 266604-3502
- Practice address
- 2900 S State St Ste 101
Salt Lake City, UT 84115-3891 - Phone
- (801) 983-5540
- Fax
- (801) 983-5542
- NPI assigned
- May 11, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 266604-3502 | UT | Primary |
Addresses
Primary practice location
2900 S State St Ste 101
Salt Lake City, UT 84115-3891
Mailing address
PO Box 521207
Salt Lake City, UT 84152-1207
Phone (801) 983-5540
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 |
|---|---|---|---|
| 266604-3502 | UT | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Silverado Counseling Services, LLC | 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 and National Provider Directory roles.
-
- Clinical Social Worker
- South Salt Lake, UT
- NPI 1154381192
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273536000000",
"number": "1063730380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 521207",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841521207",
"telephone_number": "801-983-5540",
"fax_number": "801-983-5542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 S STATE ST STE 101",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841153891",
"telephone_number": "801-983-5540",
"fax_number": "801-983-5542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "ERIC",
"middle_name": "POULSEN",
"credential": "CSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-11",
"last_updated": "2010-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "UT",
"license": "266604-3502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.