635 Community Health Collective

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

635 COMMUNITY HEALTH COLLECTIVE

Practice address

635 N 900 W
Salt Lake City, UT 84116-4002

Phone

(801) 824-1939

NPI assigned

Sep 21, 2020

Organization subpart

No

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

Authorized official

Name

Eliot Sykes, LCSWNPI 1528531761

Title

Founder & Ceo

Phone

(801) 824-1939

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eliot Sykes

  • Clinical Social Worker
  • Salt Lake City, UT
  • NPI 1528531761

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600646400000",
    "number": "1083220537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 N 900 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841164002",
            "telephone_number": "801-824-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 N 900 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841164002",
            "telephone_number": "801-824-1939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "635 COMMUNITY HEALTH COLLECTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A",
        "authorized_official_last_name": "SYKES",
        "authorized_official_first_name": "ELIOT",
        "authorized_official_title_or_position": "FOUNDER & CEO",
        "authorized_official_telephone_number": "801-824-1939",
        "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": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "635chc@simplepractice.com",
            "affiliation": "N",
            "endpointDescription": "Simple Practice",
            "address_1": "635 N 900 W",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841164002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Salt Lake City, UT
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.