Active NPI
Shawn James Evans, L.C.S.W.
- Clinical Social Worker
- Salt Lake City, UT
National Provider Identifier
1184705303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 369296-3501
- Practice address
- 132 S State St
Suite 200
Salt Lake City, UT 84111-1506 - Phone
- (801) 240-6522
- Fax
- (801) 240-3422
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 369296-3501 | UT | Primary |
Addresses
Primary practice location
132 S State St
Suite 200
Salt Lake City, UT 84111-1506
Mailing address
530 Parkview Dr
Park City, UT 84098-5203
Phone (435) 649-7871
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
| License | State | Type | Specialty |
|---|---|---|---|
| 369296-3501 | UT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LDS Family Services | Past | Accepting new patients | |
| LDS Family Services | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Sandy, UT
- NPI 1659324572
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Renton, WA
- NPI 1073726485
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184705303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 PARKVIEW DR",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840985203",
"telephone_number": "435-649-7871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 S STATE ST",
"address_2": "SUITE 200",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841111506",
"telephone_number": "801-240-6522",
"fax_number": "801-240-3422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "SHAWN",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "L.C.S.W.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "369296-3501",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.