Active NPI
Rosa Waters
- Clinical Social Worker
- Salt Lake City, UT
National Provider Identifier
1346983673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 555 Foothill Dr
Salt Lake City, UT 84112-1106 - Phone
- (801) 646-9236
- NPI assigned
- Apr 14, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
555 Foothill Dr
Salt Lake City, UT 84112-1106
Mailing address
3538 Kepuhi St
Honolulu, HI 96815-4366
Phone (804) 543-8999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 13, 2024 through Dec 13, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wild Iris Counseling LLC | Current | 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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Salt Lake City, UT
- NPI 1124902143
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714694400000",
"number": "1346983673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3538 KEPUHI ST",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968154366",
"telephone_number": "804-543-8999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 FOOTHILL DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841121106",
"telephone_number": "801-646-9236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERS",
"first_name": "ROSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-14",
"last_updated": "2024-05-03",
"certification_date": "2024-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"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 May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.