Individual provider Active NPI

Sara J Cristie, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1174569149
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
310550-3501 Issued in UT
Practice address
5965 S 900 E
Salt Lake City, UT 84121-1720
Phone
(801) 263-7100
Fax
(801) 263-7123
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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 310550-3501 UT Primary

Addresses

Primary practice location

5965 S 900 E
Salt Lake City, UT 84121-1720

Mailing address

5965 S 900 E
Salt Lake City, UT 84121-1720
Phone (801) 263-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
310550-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Central Utah Counseling Center Past Accepting new patients
Valley Behavioral Health Incorporated Clinical Past Accepting new patients
Central Utah Mental Health Past Accepting new patients
Central Utah Mental Health Substance Abuse Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1174569149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5965 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211720",
            "telephone_number": "801-263-7100",
            "fax_number": "801-263-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5965 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211720",
            "telephone_number": "801-263-7100",
            "fax_number": "801-263-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISTIE",
        "first_name": "SARA",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "310550-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.