Kirt Don Wise, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5666130-3501 Issued in UT

Practice address

387 E 450 S
Clearfield, UT 84015-1734

Phone

(801) 635-5022

Fax

(801) 773-9152

NPI assigned

Nov 25, 2008

Last updated

Apr 22, 2016By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1215182795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W 2600 S",
            "address_2": "STE 200",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107784",
            "telephone_number": "801-815-3443",
            "fax_number": "801-776-4162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 E 450 S",
            "city": "CLEARFIELD",
            "state": "UT",
            "postal_code": "840151734",
            "telephone_number": "801-635-5022",
            "fax_number": "801-773-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "KIRT",
        "middle_name": "DON",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-25",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "5666130-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashlee R Williams, DPT
• Madeline Wilson
• Sarah Wilson
• Winegars Super Markets Inc (Winegars Supermarkets)
• Rachel Ann Winsley, CBD
• Jeffrey Kirk Wood, DDS
• Kelly James Wood, PA-C
• Workability Centers, LLC (Ability Rehab and Physical Therapy)
• Jennifer Lynne Wright
• Makinlee Wright

• Clinical Social Worker in Clearfield, UT
• Providers in Clearfield, 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 Apr 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.