Individual provider Active NPI

Caroline Amis, LSAC

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1124348982
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7210961-3501 Issued in UT
Practice address
450 S 900 E
Salt Lake City, UT 84102-2981
Phone
(801) 587-2770
Fax
(801) 355-4607
NPI assigned
Jun 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 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 7210961-3501 UT Primary

Addresses

Primary practice location

450 S 900 E
Salt Lake City, UT 84102-2981

Mailing address

42 S 500 E
Salt Lake City, UT 84102-1002
Phone (801) 428-3419

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
7210961-3501UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1124348982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 S 500 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021002",
            "telephone_number": "801-428-3419",
            "fax_number": "801-355-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022981",
            "telephone_number": "801-587-2770",
            "fax_number": "801-355-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIS",
        "first_name": "CAROLINE",
        "credential": "LSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "7210961-3501",
            "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 May 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.