Annelise Larue Jolley

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

75 E Fort Union Blvd Ste C118
Midvale, UT 84047-5512

Phone

(801) 792-4867

NPI assigned

Nov 20, 2023

Last updated

Nov 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Project Reality

  • Mental Health Counselor
  • Salt Lake City, UT
  • NPI 1134211626
  Medicare reassignment NPD

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1205601218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 E FORT UNION BLVD STE C118",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840475512",
            "telephone_number": "801-792-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 E FORT UNION BLVD STE C118",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840475512",
            "telephone_number": "801-792-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLEY",
        "first_name": "ANNELISE",
        "middle_name": "LARUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hena John-Fisk, CSWI
• Nicole Marie Johnson, PA-C
• Shawnee Johnson
• Tanner Derek Nephi Johnson
• Jared Alan Johnstun, M.D.
• Carlee Marie Jones, LCSW
• Leah Jones
• Megan Elizabeth Jones
• Sandra Lynn Jones
• Joor Interpretation Exchange Inc.

• Clinical Social Worker in Midvale, UT
• Providers in Midvale, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.