Active NPI
McKenzie Anderson
- Clinical Social Worker
- Sandy, UT
National Provider Identifier
1194404731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11907594-3502
- Practice address
- 8524 S 1300 E
Sandy, UT 84094-1366 - Phone
- (385) 337-1139
- NPI assigned
- Jul 12, 2023
- Last updated
- Jul 12, 2023
- Sex
- Female
- 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 | 11907594-3502 | UT | Primary |
Addresses
Primary practice location
8524 S 1300 E
Sandy, UT 84094-1366
Mailing address
1099 S 550 W
Spanish Fork, UT 84660-4656
Phone (801) 473-0822
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11907594-3502 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689120000000",
"number": "1194404731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1099 S 550 W",
"city": "SPANISH FORK",
"state": "UT",
"postal_code": "846604656",
"telephone_number": "801-473-0822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8524 S 1300 E",
"city": "SANDY",
"state": "UT",
"postal_code": "840941366",
"telephone_number": "385-337-1139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "MCKENZIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-12",
"last_updated": "2023-07-12",
"certification_date": "2022-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "11907594-3502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.