Jill M Zablocki, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

9226522-2501 Issued in UT

Practice address

574 E 12TH Ave
Salt Lake City, UT 84103-3224

Phone

(801) 875-1926

Fax

(646) 843-4713

NPI assigned

Jan 28, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 10, 2020 through Jan 10, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478217600000",
    "number": "1164609665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "574 E 12TH AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841033224",
            "telephone_number": "801-875-1926",
            "fax_number": "646-843-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "574 E 12TH AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841033224",
            "telephone_number": "801-875-1926",
            "fax_number": "646-843-4713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZABLOCKI",
        "first_name": "JILL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-28",
        "last_updated": "2016-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "017071",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "5088",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "9226522-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lily Zabala
• Pierre Douglas Zabel, D.O.
• Anahita Noelle Zabihi Gilvan
• Gabriela Zabka, CSW
• Hannah Marie Zabka
• Barbara Zabriskie
• Norman A. Zabriskie, MD
• Ryan Adam Zabriskie, LCMHC
• Zachary Paul Zabriskie, MD
• Brittnee Zacherson, RN

• Clinical Psychologist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Clinical Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.