Individual provider Active NPI

Stephen Havertz, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1326405333
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
140331-3501 Issued in UT
Practice address
4460 S Highland Dr
Salt Lake City, UT 84124-3543
Phone
(888) 949-4864
NPI assigned
Jan 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 140331-3501 UT Primary

Addresses

Primary practice location

4460 S Highland Dr
Salt Lake City, UT 84124-3543

Mailing address

3725 W 4100 S
West Valley City, UT 84120-5411
Phone (888) 949-4864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
140331-3501UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1453334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1326405333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 W 4100 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841205411",
            "telephone_number": "888-949-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 S HIGHLAND DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841243543",
            "telephone_number": "888-949-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERTZ",
        "first_name": "STEPHEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-21",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "140331-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.