Individual provider Active NPI

Emogene Elizabeth Hennick-Dunn, MSW, LCSW, PHD

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1326695990
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6656294-3501 Issued in UT
Practice address
4460 S Highland Dr
Salt Lake City, UT 84124-3543
Phone
(888) 949-4864
NPI assigned
Aug 19, 2019
Last updated
Sep 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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 6656294-3501 UT Primary

Addresses

Primary practice location

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

Mailing address

1058 Chidester Dr
North Salt Lake, UT 84054-5007
Phone (801) 859-2421

Other practice location 1

555 Foothill Dr
Salt Lake City, UT 84112-1106
Phone (801) 213-8758

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
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1326695990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1058 CHIDESTER DR",
            "city": "NORTH SALT LAKE",
            "state": "UT",
            "postal_code": "840545007",
            "telephone_number": "801-859-2421"
        },
        {
            "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": [
        {
            "address_1": "555 Foothill Dr",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841121106",
            "country_code": "US",
            "telephone_number": "801-213-8758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNICK-DUNN",
        "first_name": "EMOGENE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MSW, LCSW, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "6656294-3501",
            "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 20, 2022; 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.