Susan Michelle Bollow, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7046059-3502 Issued in UT

Practice address

4434 S Highland Dr
Millcreek, UT 84124-3533

Phone

(385) 321-3109

NPI assigned

Jun 4, 2009

Last updated

Sep 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Susan Michelle Thorn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Soul Logic Counseling

  • Clinical Social Worker
  • Millcreek, UT
  • NPI 1124853239
  NPD Authorized official
• Center for Human Potential

  • Community/Behavioral Health Agency
  • Salt Lake City, UT
  • NPI 1366679441
  NPD

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1275769259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2734 E CANTON LN",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840927125",
            "telephone_number": "801-574-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4434 S HIGHLAND DR",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841243533",
            "telephone_number": "385-321-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLOW",
        "first_name": "SUSAN",
        "middle_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "7046059-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "THORN",
            "middle_name": "MICHELLE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Beck Family Therapy PLLC (Red Fox Counseling)
• Amber Bingham, RBT
• Jennifer Lynn Bishop, PHARMD
• Body and Mind Collective, LLC
• Lisa L Boice, LCSW
• Eric Bonin, TRS, CTRS
• Lindsay Elizabeth Born, DPT
• Gwyneth Grace Borzoni
• Elizabeth Bosen, MSW
• Sheri Bowden, ACMHC

• Clinical Social Worker in Millcreek, UT
• Providers in Millcreek, 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 Sep 6, 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.