Individual provider Active NPI

Elizabeth Baker McCoy, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1174134860
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
260995-3501 Issued in UT
Practice address
1872 S 1600 E
Salt Lake City, UT 84105-3872
Phone
(801) 633-0610
NPI assigned
Aug 14, 2020
Last updated
Jan 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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 260995-3501 UT Primary

Addresses

Primary practice location

1872 S 1600 E
Salt Lake City, UT 84105-3872

Mailing address

1872 S 1600 E
Salt Lake City, UT 84105-3872
Phone (801) 486-1272

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210226002590 UT Practitioner - Clinical Social Worker 7618382581 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Utah School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1872 S 1600
Salt Lake City, UT 84105-3872

275 E S Temple
Suite 320
Salt Lake City, UT 84111-1247
Phone (801) 486-1272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Numinus Wellness Ut Inc CurrentSince Aug 6, 2021 Accepting new patients
Ogden Internal Medicine & Urology LLC PastSince Aug 6, 2021 Accepting new patients
David T Hakanson DC PLLC PastSince Feb 14, 2021 Accepting new patients

Locations

48 N 1100 E
Ste B
American Fork, UT 84003
Phone (801) 492-9934

721 E 12200 S
#101
Draper, UT 84020

2950 N Church St
Ste 101
Layton, UT 84040
Phone (801) 771-7202

154 E Myrtle Ave
Ste 204
Salt Lake City, UT 84107
Phone (801) 266-9300

672 W 400 S
Ste 201
Springville, UT 84663
Phone (435) 621-5224

Interoperability endpoints

  • Direct secure messaging: elizabeth.mccoy.1@17324.direct.athenahealth.com

Organizations & group practices 4

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": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1174134860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1872 S 1600 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053872",
            "telephone_number": "801-486-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1872 S 1600 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053872",
            "telephone_number": "801-633-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "ELIZABETH",
        "middle_name": "BAKER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-14",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "260995-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.