Russell Allan Pryor, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

318362-3501 Issued in UT

Practice address

3558 Brookshire Dr
Syracuse, UT 84075-9829

Phone

(801) 718-2889

NPI assigned

Mar 11, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Valley Behavioral Health Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Valley City, UT
  • NPI 1932166980

  Clinical

  Medicare reassignment NPD
• Valley Mental Health Incorporated

  • Psychiatry Physician
  • Salt Lake City, UT
  • NPI 1275599797

  Clinical

  NPD

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

{
    "created_epoch": "1299801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299801600000",
    "number": "1144528357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3558 BROOKSHIRE DR",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "840759829",
            "telephone_number": "801-718-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3558 BROOKSHIRE DR",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "840759829",
            "telephone_number": "801-718-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYOR",
        "first_name": "RUSSELL",
        "middle_name": "ALLAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-11",
        "last_updated": "2011-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "318362-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charis Phillips, HEALTH COACH
• Picnic Creek LLC (Beehive Homes of Syracuse)
• Aimee Jo Poe, OWNER
• Connie Powell, LCSW
• Private Healthcare Facilities
• Purple Chair Holdings LLC (Purple Chair Assisted Living)
• Cassandra Celeste Quick, LCSW
• Leslie May Arconada Reed, RDN, CD
• Eloise Ribeiro
• Kate Richardson, CMHC

• Clinical Social Worker in Syracuse, UT
• Providers in Syracuse, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.