Jay A. Eldredge, CSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

278462-3502 Issued in UT

Practice address

49 E 200 S
Clearfield, UT 84015

Phone

(801) 779-0095

NPI assigned

Sep 17, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Northern Utah Counseling LLC

  • Mental Health Counselor
  • Clearfield, UT
  • NPI 1063843308
  NPD (past)

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1154971588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2256 E 3225 N",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840408482",
            "telephone_number": "801-678-6122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 E 200 S",
            "city": "CLEARFIELD",
            "state": "UT",
            "postal_code": "84015",
            "telephone_number": "801-779-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDREDGE",
        "first_name": "JAY",
        "middle_name": "A.",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-17",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "278462-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristiane Madsen Donat, LMFT
• Doris Oasis
• Javoris Douglas
• Amber Earl, MASSAGE THERAPIST
• Amanda Michelle Edmunds
• Elevate Integration Bodyworks
• Elite Counseling Services
• Michael Elmer
• Empowerment Counseling Services
• Jason L. English

• Clinical Social Worker in Clearfield, UT
• Providers in Clearfield, 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 Sep 17, 2019; 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.