Payton Joy Pola, CSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11295957-3502 Issued in UT

Practice address

1108 W S Jordan Pkwy Ste B
South Jordan, UT 84095-5505

Phone

(385) 215-9084

NPI assigned

Sep 6, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: hope&healing.paytonpola@145836.advancedmd-direct.com

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1356823249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 W S JORDAN PKWY STE B",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955505",
            "telephone_number": "385-215-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 W S JORDAN PKWY STE B",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955505",
            "telephone_number": "385-215-9084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6013 S Redwood Rd",
            "address_purpose": "LOCATION",
            "city": "Taylorsville",
            "state": "UT",
            "postal_code": "841235220",
            "country_code": "US",
            "telephone_number": "801-255-5131",
            "fax_number": "801-658-0604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLA",
        "first_name": "PAYTON",
        "middle_name": "JOY",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "11295957-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; 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.