NPIMap

Organization Active NPI

Kelsey Kim, LLC

  • Clinical Social Worker
  • Layton, UT
National Provider Identifier
1245628866
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
70870873501 Issued in UT
Legal business name
KELSEY KIM, LLC
Practice address
2317 N Hill Field Rd Ste 103
Layton, UT 84041-4782
Phone
(801) 900-3765
NPI assigned
Jan 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Authorized official

Name
Ms. Kelsey Kim Barrus, LCSW
Title
Clinical Therapist/Owner
Phone
(801) 900-3765

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 70870873501 UT Primary

Addresses

Primary practice location

2317 N Hill Field Rd Ste 103
Layton, UT 84041-4782

Mailing address

2317 N Hill Field Rd Ste 103
Layton, UT 84041-4782

Other identifiers 1

IdentifierTypeStateIssuer
1629197447MedicaidUT

National Provider Directory

National Provider Directory

Locations

2317 N Hill Field Rd
Ste 103
Layton, UT 84041
Phone (801) 913-1212

NPI Registry JSON

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420416000000",
    "number": "1245628866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 N HILL FIELD RD STE 103",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 N HILL FIELD RD STE 103",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414782",
            "telephone_number": "801-900-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELSEY KIM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-01-05",
        "status": "A",
        "authorized_official_last_name": "BARRUS",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_middle_name": "KIM",
        "authorized_official_title_or_position": "CLINICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "801-900-3765",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "70870873501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629197447",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; 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.