Active NPI
Sheila Michelle Jacobson Long, CSW
- Clinical Social Worker
- Taylorsville, UT
National Provider Identifier
1275933160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 9816324-3502
- Practice address
- 2880 W 4700 S
G-1
Taylorsville, UT 84129-2156 - Phone
- (801) 613-7490
- NPI assigned
- Aug 27, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Clinical Social Worker | 1041C0700X | 9816324-3502 | UT | Primary |
Addresses
Primary practice location
2880 W 4700 S
G-1
Taylorsville, UT 84129-2156
Mailing address
2880 W 4700 S
G-1
Taylorsville, UT 84129-2156
Phone (801) 613-7490
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9816324-3502 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481673600000",
"number": "1275933160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2880 W 4700 S",
"address_2": "G-1",
"city": "TAYLORSVILLE",
"state": "UT",
"postal_code": "841292156",
"telephone_number": "801-613-7490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2880 W 4700 S",
"address_2": "G-1",
"city": "TAYLORSVILLE",
"state": "UT",
"postal_code": "841292156",
"telephone_number": "801-613-7490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON LONG",
"first_name": "SHEILA",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "CSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-27",
"last_updated": "2016-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "9816324-3502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taylorsville, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; 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.