Individual provider Active NPI

Jon R Worlton, LCSW

  • Clinical Social Worker
  • St George, UT
National Provider Identifier
1104132372
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1410563501 Issued in UT
Practice address
393 E Riverside Dr Ste 3a
St George, UT 84790-7127
Phone
(435) 688-2123
Fax
(801) 877-0864
NPI assigned
Aug 26, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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 1410563501 UT Primary

Addresses

Primary practice location

393 E Riverside Dr Ste 3a
St George, UT 84790-7127

Mailing address

4626 N 300 W Ste 150
Provo, UT 84604-6077
Phone (435) 688-2123

Other names 1

  • Jon Wortlon Other name

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

LicenseStateTypeSpecialty
1410563501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sela Health, PLLC Clinical PastSince Apr 25, 2021 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.

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1104132372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4626 N 300 W STE 150",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046077",
            "telephone_number": "435-688-2123",
            "fax_number": "801-877-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 E RIVERSIDE DR STE 3A",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907127",
            "telephone_number": "435-688-2123",
            "fax_number": "801-877-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORLTON",
        "first_name": "JON",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-26",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "1410563501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JON",
            "last_name": "WORTLON",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.