Active NPI
Justin Naylor
- Social Worker
- Salt Lake City, UT
National Provider Identifier
1093025926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 287380-3502
- Practice address
- 4444 S 700 E Ste 203
Salt Lake City, UT 84107-3075 - Phone
- (801) 598-0743
- Fax
- (801) 606-7445
- NPI assigned
- Oct 13, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Social Worker | 104100000X | 287380-3502 | UT | Primary |
Addresses
Primary practice location
4444 S 700 E Ste 203
Salt Lake City, UT 84107-3075
Mailing address
13923 Haystack Peak Cir
Riverton, UT 84096-6453
Phone (801) 598-0743
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 |
|---|---|---|---|
| 287380-3502 | UT | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affinity Behavior and Mental Health Services, LLC | Past | Accepting new patients | |
| Community Treatment Alternatives | Behavior Analyst | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba CTA Community Supports
- Community/Behavioral Health Agency
- Murray, UT
- NPI 1972895290
Behavior Analyst
-
- Community/Behavioral Health Agency
- West Jordan, UT
- NPI 1912242918
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420416000000",
"number": "1093025926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13923 HAYSTACK PEAK CIR",
"city": "RIVERTON",
"state": "UT",
"postal_code": "840966453",
"telephone_number": "801-598-0743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4444 S 700 E STE 203",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841073075",
"telephone_number": "801-598-0743",
"fax_number": "801-606-7445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAYLOR",
"first_name": "JUSTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-13",
"last_updated": "2015-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "UT",
"license": "287380-3502",
"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 Jan 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.