Christina M Utterback, MSW LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34005515A Issued in IN

Practice address

415 Mulberry Street
Evansville, IN 47713-1230

Phone

(812) 423-7791

Fax

(812) 422-7558

NPI assigned

May 8, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1164699260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MULBERRY STREET",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131230",
            "telephone_number": "812-423-7791",
            "fax_number": "812-422-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MULBERRY STREET",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131230",
            "telephone_number": "812-423-7791",
            "fax_number": "812-422-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTTERBACK",
        "first_name": "CHRISTINA",
        "middle_name": "M",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005515A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100240880",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000570332",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11851765",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• V & W Staffing, LLC
• Joshua Grant Vaal, MSW, LCSW
• Valley Neuro Monitoring LLC

• Clinical Social Worker in Evansville, IN
• Providers in Evansville, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; 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.