Individual provider Active NPI

Steven Reed Prentice, LCSW

  • Clinical Social Worker
  • West Valley City, UT
National Provider Identifier
1376856286
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2880 W 4700 S
Suite B
West Valley City, UT 84118-2156
Phone
(801) 982-1404
Fax
(801) 982-1365
NPI assigned
Jul 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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 UT Primary

Addresses

Primary practice location

2880 W 4700 S
Suite B
West Valley City, UT 84118-2156

Mailing address

2880 W 4700 S
Suite B
West Valley City, UT 84118-2156
Phone (801) 982-1404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20240313001027 VT Practitioner - Clinical Social Worker 3274775291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brattleboro RetreatGroup PAC ID 7012828908, 61 clinicians

Practice addresses (Care Compare)

22 Anna Marsh LN
Dummerston, VT 05301-3292
Phone (802) 258-4391

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brattleboro Retreat CurrentSince Jan 7, 2024 Accepting new patients
Ensign Peak Services, Inc. Past Accepting new patients
Ensign Peak Services Inc. Past Accepting new patients
Brattleboro Retreat Past Accepting new patients

Locations

22 Anna Marsh Ln
Dummerston, VT 05301
Phone (802) 258-3700

1 Anna Marsh Ln
Dummerston, VT 05301

Organizations & group practices 4

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": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279584000000",
    "number": "1376856286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 W 4700 S",
            "address_2": "SUITE B",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841182156",
            "telephone_number": "801-982-1404",
            "fax_number": "801-982-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 W 4700 S",
            "address_2": "SUITE B",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841182156",
            "telephone_number": "801-982-1404",
            "fax_number": "801-982-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENTICE",
        "first_name": "STEVEN",
        "middle_name": "REED",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-20",
        "last_updated": "2010-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

Verify at the official NPI Registry.