Active NPI
Holly R Earl
- Clinical Social Worker
- SLC, UT
National Provider Identifier
1366516775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 133518-3501
- Practice address
- 1400 Foothill Dr
#112
SLC, UT 84108-2327 - Phone
- (801) 759-0101
- NPI assigned
- Nov 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 133518-3501 | UT | Primary |
Addresses
Primary practice location
1400 Foothill Dr
#112
SLC, UT 84108-2327
Mailing address
PO Box 71736
Salt Lake City, UT 84171-0736
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 76636 | Other | UT | PEHP |
| 278803 | Other | UT | DMBA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 133518-3501 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366516775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 71736",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841710736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 FOOTHILL DR",
"address_2": "#112",
"city": "SLC",
"state": "UT",
"postal_code": "841082327",
"telephone_number": "801-759-0101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EARL",
"first_name": "HOLLY",
"middle_name": "R",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "133518-3501",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEHP",
"identifier": "76636",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMBA",
"identifier": "278803",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in SLC, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.