Individual provider Active NPI

Corrie Frances Agnew, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1376976860
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7748697-3501 Issued in UT
Practice address
1945 S 1100 E
Suite 202
Salt Lake City, UT 84106-2369
Phone
(801) 657-0897
NPI assigned
Aug 20, 2013
Last updated
Feb 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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 7748697-3501 UT Primary

Addresses

Primary practice location

1945 S 1100 E
Suite 202
Salt Lake City, UT 84106-2369

Mailing address

1049 S Pueblo St
Salt Lake City, UT 84104-3232
Phone (801) 388-8574

Other practice location 1

123 E Main St
Sandy, UT 84070-1509
Phone (801) 388-8574

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

NPI Registry JSON

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1376976860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 S PUEBLO ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841043232",
            "telephone_number": "801-388-8574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 S 1100 E",
            "address_2": "SUITE 202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062369",
            "telephone_number": "801-657-0897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 E Main St",
            "address_purpose": "LOCATION",
            "city": "Sandy",
            "state": "UT",
            "postal_code": "840701509",
            "country_code": "US",
            "telephone_number": "801-388-8574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGNEW",
        "first_name": "CORRIE",
        "middle_name": "FRANCES",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "7748697-3501",
            "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 Feb 27, 2024; 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.