Individual provider Active NPI

Jeanette M Ricci, LCSW

  • Clinical Social Worker
  • Taylorsville, UT
National Provider Identifier
1114340650
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
131120-3501 Issued in UT
Practice address
5770 S 1500 W
Taylorsville, UT 84123-5216
Phone
(801) 313-7940
NPI assigned
Feb 3, 2014
Last updated
Apr 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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 131120-3501 UT Primary

Addresses

Primary practice location

5770 S 1500 W
Taylorsville, UT 84123-5216

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 313-7940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140328002224 UT Practitioner - Clinical Social Worker 8022249366 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
131120-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Mar 7, 2022 Accepting new patients
Ihc Health Services Inc CurrentSince Mar 7, 2022 Accepting new patients
Valley Mental Health Incorporated Clinical Current Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1225 E Fort Union Blvd
Ste 315
Midvale, UT 84047
Phone (801) 233-4100

5770 S 1500 W
Taylorsville, UT 84123
Phone (801) 265-3000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1114340650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-313-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 S 1500 W",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841235216",
            "telephone_number": "801-313-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICCI",
        "first_name": "JEANETTE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-03",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "131120-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylorsville, UT

Sources for this page

Verify at the official NPI Registry.