NPIMap

Individual provider Active NPI

Matthew Jerald Seelos, L.C.S.W.

  • Clinical Social Worker
  • Layton, UT
National Provider Identifier
1346676640
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
49131003501 Issued in UT
Practice address
639 Rose Blossom Dr
Layton, UT 84041-4258
Phone
(801) 824-5355
NPI assigned
Sep 18, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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 49131003501 UT Primary

Addresses

Primary practice location

639 Rose Blossom Dr
Layton, UT 84041-4258

Mailing address

639 Rose Blossom Dr
Layton, UT 84041-4258
Phone (801) 824-5355

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
49131003501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Ocd and Anxiety Treatment Center Clinical Past Accepting new patients
The Counseling Center LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1346676640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 ROSE BLOSSOM DR",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414258",
            "telephone_number": "801-824-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 ROSE BLOSSOM DR",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414258",
            "telephone_number": "801-824-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEELOS",
        "first_name": "MATTHEW",
        "middle_name": "JERALD",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-18",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "49131003501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; 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.