Kristina Muck, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10658720-3501 Issued in UT

Practice address

6150 S Redwood Rd
Taylorsville, UT 84123-5308

Phone

(801) 342-2283

NPI assigned

May 12, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

State licenses

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.

• Odyssey House Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Salt Lake City, UT
  • NPI 1033143706
  Medicare reassignment

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1225565930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8014 W PLEASANT GREEN DR",
            "city": "MAGNA",
            "state": "UT",
            "postal_code": "840443423",
            "telephone_number": "801-250-2158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 S REDWOOD RD",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841235308",
            "telephone_number": "801-342-2283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "322 East 100 South",
            "address_2": "Suite 301",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "84111",
            "country_code": "US",
            "telephone_number": "801-322-4257",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 E 2100 S Ste 301",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841152266",
            "country_code": "US",
            "telephone_number": "801-322-2222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUCK",
        "first_name": "KRISTINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-12",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "10658720-3502",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "10658720-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriel Moton
• Luke Mott
• Madison Moulton
• Jenika Moultrie
• Mary Moyle
• Karli Muir
• Briana Mulato
• Tausoa Mulitalo
• Megan Mullalley, PHARMD
• Emmalie Mullins

• Clinical Social Worker in Taylorsville, UT
• Providers in Taylorsville, 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 Feb 27, 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.