Individual provider Active NPI

Marc Lee Anson, LCSW

  • Clinical Social Worker
  • Syracuse, UT
National Provider Identifier
1144486895
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5780998-3501 Issued in UT
Practice address
1747 Heritage LN Ste B101
Syracuse, UT 84075-8546
Phone
(385) 439-1926
NPI assigned
Aug 1, 2008
Last updated
Dec 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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 5780998-3501 UT Primary

Addresses

Primary practice location

1747 Heritage LN Ste B101
Syracuse, UT 84075-8546

Mailing address

1141 W 3090 S
Syracuse, UT 84075-9083
Phone (801) 791-2073

Other identifiers 1

IdentifierTypeStateIssuer
876000308007MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5780998-3501UTMDClinical Social Worker

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, 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": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1144486895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 W 3090 S",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "840759083",
            "telephone_number": "801-791-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 HERITAGE LN STE B101",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "840758546",
            "telephone_number": "385-439-1926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSON",
        "first_name": "MARC",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-01",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "5780998-3501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "876000308007",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, UT

Sources for this page

Verify at the official NPI Registry.