Individual provider Active NPI

Else Rose Havili, LCSW

  • Social Worker
  • Salt Lake City, UT
National Provider Identifier
1205578929
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
13408619-3501 Issued in UT
Practice address
4000 S 700 E Ste 9
Salt Lake City, UT 84107-2581
Phone
(801) 639-9544
Fax
(801) 263-4333
NPI assigned
Apr 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 13408619-3501 UT Primary

Addresses

Primary practice location

4000 S 700 E Ste 9
Salt Lake City, UT 84107-2581

Mailing address

4000 S 700 E Ste 9
Salt Lake City, UT 84107-2581
Phone (801) 639-9544

Other names 1

  • Else Rose Peterson Former name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13408619-3502UTMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1205578929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 S 700 E STE 9",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072581",
            "telephone_number": "801-639-9544",
            "fax_number": "801-263-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 S 700 E STE 9",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072581",
            "telephone_number": "801-639-9544",
            "fax_number": "801-263-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVILI",
        "first_name": "ELSE",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "13408619-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELSE",
            "last_name": "PETERSON",
            "middle_name": "ROSE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.