Clifford S Woodall, BCBA, SSW

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

3107107-2506 Issued in UT

Practice address

240 N East Promontory Ste 200
Farmington, UT 84025-2950

Phone

(385) 245-2151

Fax

(801) 255-5131

NPI assigned

Mar 1, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

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": "1488326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1235679895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N EAST PROMONTORY STE 200",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252950",
            "telephone_number": "385-245-2151",
            "fax_number": "801-255-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 N EAST PROMONTORY STE 200",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252950",
            "telephone_number": "385-245-2151",
            "fax_number": "801-255-5131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "657 N Kays Dr",
            "address_purpose": "LOCATION",
            "city": "Kaysville",
            "state": "UT",
            "postal_code": "840376764",
            "country_code": "US",
            "telephone_number": "385-245-2151",
            "fax_number": "385-235-7760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODALL",
        "first_name": "CLIFFORD",
        "middle_name": "S",
        "credential": "BCBA, SSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-01",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "UT",
            "license": "3107107-3503",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "UT",
            "license": "3107107-2506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Blair Willis, M.D.
• Marianne Margaret Wilson
• Linda Winn, CCC-SLP
• Shauna Wolferts, LCSW
• Erin Nicole Wolthuis, ACMHC
• Becky Garrett Wooten
• Ashley Wright
• Trenton McNeil Wright, M.D.
• Olive Yeates, RBT
• Sean Brent Young, FNP, CRNA/APRN

• Behavior Analyst in Farmington, UT
• Providers in Farmington, UT by specialty
• Behavior Analyst in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.