NPIMap

Sammie June Bateman, MSW, LCSW

Individual provider Active NPI Clinical Social Worker · Salt Lake City, UT

NPI 1194802900 · NPPES record last updated Jul 13, 2016

Key facts

NPI
1194802900
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
9441174-3501 (UT)
Practice address
4460 S Highland Dr
Suite 230
Salt Lake City, UT 84124-3543
Phone
(888) 949-4864
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2455-CARMDClinical Social Worker
C5669MSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred PHP LLC Past
since May 9, 2021		 Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C5669 MS
Clinical Social Worker 1041C0700X 2455-C AR
Clinical Social Worker 1041C0700X 9441174-3501 UT Yes

Addresses

Primary practice location

4460 S Highland Dr
Suite 230
Salt Lake City, UT 84124-3543

Mailing address

4460 S Highland Dr
Suite 230
Salt Lake City, UT 84124-3543
Phone (888) 949-4864

Other providers in Salt Lake City, UT

All providers in Salt Lake City, UT · Clinical Social Worker in Utah

Sources for this page

Verify at the official NPI Registry.