Individual provider Active NPI

Christina A Mikesell, LCSW

  • Clinical Social Worker
  • Layton, UT
National Provider Identifier
1366051252
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12304780-3501 Issued in UT
Practice address
934 S Main St
Layton, UT 84041-7135
Phone
(801) 773-7060
NPI assigned
Jul 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 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 12304780-3501 UT Primary

Addresses

Primary practice location

934 S Main St
Layton, UT 84041-7135

Mailing address

934 S Main St
Layton, UT 84041-7135
Phone (801) 773-7060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230103002678 UT Practitioner - Clinical Social Worker 0244600484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Davis Behavioral Health IncGroup PAC ID 7416861919, 61 clinicians

Practice addresses (Care Compare)

934 S Main St
Layton, UT 84041-7135
Phone (801) 773-7060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Davis Behavioral Health Inc Social Worker CurrentSince Dec 12, 2022 Accepting new patients

Locations

934 S Main St
Layton, UT 84041
Phone (801) 336-1845

1799 Antelope Dr
Syracuse, UT 84075

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.

NPI Registry JSON

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1366051252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 S MAIN ST",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417135",
            "telephone_number": "801-773-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 S MAIN ST",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417135",
            "telephone_number": "801-773-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKESELL",
        "first_name": "CHRISTINA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-27",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "12304780-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.