Individual provider Active NPI

Anjuli McKell Lineback, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1386110039
Registry record updated Oct 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10170686-3501 Issued in UT
Practice address
1104 E Ashton Ave Ste 103
Salt Lake City, UT 84106-2348
Phone
(801) 259-7321
NPI assigned
Oct 21, 2018
Last updated
Oct 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2018

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 10170686-3501 UT Primary

Addresses

Primary practice location

1104 E Ashton Ave Ste 103
Salt Lake City, UT 84106-2348

Mailing address

1417 E 3000 S
Salt Lake City, UT 84106-3444
Phone (801) 259-7311

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10170686-3501UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1540080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540080000000",
    "number": "1386110039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 E 3000 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063444",
            "telephone_number": "801-259-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 E ASHTON AVE STE 103",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062348",
            "telephone_number": "801-259-7321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINEBACK",
        "first_name": "ANJULI",
        "middle_name": "MCKELL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-21",
        "last_updated": "2018-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "10170686-3501",
            "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 Oct 21, 2018; 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.