Individual provider Active NPI

Melinda White

  • Clinical Social Worker
  • South Jordan, UT
National Provider Identifier
1336500362
Registry record updated Apr 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
379066-3501 Issued in UT
Practice address
885 W Baxter Dr
South Jordan, UT 84095-8506
Phone
(801) 599-5119
NPI assigned
Mar 18, 2016
Last updated
Apr 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2019

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 379066-3501 UT Primary

Addresses

Primary practice location

885 W Baxter Dr
South Jordan, UT 84095-8506

Mailing address

11883 S Poultry Dr
Draper, UT 84020-6812
Phone (801) 599-5119

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
379066-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Heart Stone Counseling LLC Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554508800000",
    "number": "1336500362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11883 S POULTRY DR",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840206812",
            "telephone_number": "801-599-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 W BAXTER DR",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958506",
            "telephone_number": "801-599-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MELINDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-18",
        "last_updated": "2019-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "379066-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2019; 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.