NPIMap

Organization Active NPI

Serenity Recovery and Wellness

  • Clinical Social Worker
  • Riverton, UT
National Provider Identifier
1316493521
Registry record updated Nov 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8699899-3501 Issued in UT
Legal business name
SERENITY RECOVERY AND WELLNESS
Practice address
12447 S Crossing Dr Ste 13
Riverton, UT 84096-7020
Phone
(801) 984-0184
Fax
(801) 984-0186
NPI assigned
Aug 28, 2016
Last updated
Nov 7, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2017

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

Authorized official

Name
Lyndsey Proctor, LCSWNPI 1750617791
Title
Executive Director
Phone
(801) 618-7331

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 8699899-3501 UT Primary

Addresses

Primary practice location

12447 S Crossing Dr Ste 13
Riverton, UT 84096-7020

Mailing address

12447 S Crossing Dr
13
Riverton, UT 84096
Phone (801) 984-0184

National Provider Directory

National Provider Directory

Locations

12447 S Crossing Dr
Ste 13
Riverton, UT 84096
Phone (801) 984-0184

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510012800000",
    "number": "1316493521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12447 S CROSSING DR",
            "address_2": "13",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "84096",
            "telephone_number": "801-984-0184",
            "fax_number": "801-984-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12447 S CROSSING DR STE 13",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840967020",
            "telephone_number": "801-984-0184",
            "fax_number": "801-984-0186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY RECOVERY AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-28",
        "last_updated": "2017-11-07",
        "status": "A",
        "authorized_official_last_name": "PROCTOR",
        "authorized_official_first_name": "LYNDSEY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-618-7331",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "8699899-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2017; 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.