Active NPI
A Michelle Jones, LCSW
- Clinical Social Worker
- Provo, UT
National Provider Identifier
1265509269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4792258-3501
- Practice address
- 3507 N University Ave
Suite 350
Provo, UT 84604 - Phone
- (801) 434-8803
- Fax
- (801) 384-0780
- NPI assigned
- Nov 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4792258-3501 | UT | Primary |
Addresses
Primary practice location
3507 N University Ave
Suite 350
Provo, UT 84604
Mailing address
3507 N University Ave
Suite 350
Provo, UT 84604-4478
Phone (801) 434-8803
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2023 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395792000000",
"number": "1265509269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3507 N UNIVERSITY AVE",
"address_2": "SUITE 350",
"city": "PROVO",
"state": "UT",
"postal_code": "846044478",
"telephone_number": "801-434-8803",
"fax_number": "801-384-0780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3507 N UNIVERSITY AVE",
"address_2": "SUITE 350",
"city": "PROVO",
"state": "UT",
"postal_code": "84604",
"telephone_number": "801-434-8803",
"fax_number": "801-384-0780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "A",
"middle_name": "MICHELLE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-29",
"last_updated": "2014-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "4792258-3501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.