Melissa Weathers, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7196782-3501 Issued in UT

Practice address

251 S Mountain Rd Ste 1
Fruit Heights, UT 84037-2371

Phone

(801) 510-5756

NPI assigned

Apr 12, 2011

Sex

Female

Sole proprietor

Yes

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.

• Optimal Self LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fruit Heights, UT
  • NPI 1932833456

  Clinical, UT

  Medicare reassignment NPD
• Dynamic Arts PLLC

  • Clinical Social Worker
  • Fruit Heights, UT
  • NPI 1932089224

  Clinical

  NPD Authorized official

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

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 6, 2024.

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1235429168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2067 E 1200 N",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840407756",
            "telephone_number": "801-510-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 S MOUNTAIN RD STE 1",
            "city": "FRUIT HEIGHTS",
            "state": "UT",
            "postal_code": "840372371",
            "telephone_number": "801-510-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERS",
        "first_name": "MELISSA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-12",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "7196782-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keshele Elizabeth Stevens, RDN
• Taylor Stevens, PTA
• Alexis Alayne Stokes, APRN
• Robert Thurston Taft, DC
• Carol B Tanner, CRNA

• All providers in Fruit Heights, UT
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.