Nicole Dahlgren, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

7510233-3502 Issued in UT

Practice address

11620 S State St Ste 1404
Draper, UT 84020-7124

Phone

(801) 867-4488

NPI assigned

May 13, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Rooted Counseling & Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Draper, UT
  • NPI 1487245593
  NPD
• The Healing Journey Therapy Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Draper, UT
  • NPI 1700439460
  NPD

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1104144203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 W 5600 N",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023512",
            "telephone_number": "435-770-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11620 S STATE ST STE 1404",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207124",
            "telephone_number": "801-867-4488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "237 26th St",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "844013105",
            "country_code": "US",
            "telephone_number": "801-625-3700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAHLGREN",
        "first_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-13",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "7510233-3502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "260022408",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "876000308007",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicki@rootedut.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "11620 S State St Ste 1404",
            "city": "Draper",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840207124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dustin Cutler
• Austin Cymanski
• Susan Da Rosa
• April Dabb
• Julian Dahl
• Elizabeth Dalley, ACMHC
• Kara Damjanovich
• Clark Alan Dana, DDS
• Helen Dantes
• Melanie Davey

• Social Worker in Draper, UT
• Providers in Draper, UT by specialty
• Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.