Individual provider Active NPI

Joshua Yates, LCSW

  • Clinical Social Worker
  • South Jordan, UT
National Provider Identifier
1396489480
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11285653-3501 Issued in UT
Practice address
10808 S River Front Pkwy Ste 352
South Jordan, UT 84095-6100
Phone
(704) 886-4075
NPI assigned
Apr 25, 2022
Last updated
Sep 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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 11285653-3501 UT Primary

Addresses

Primary practice location

10808 S River Front Pkwy Ste 352
South Jordan, UT 84095-6100

Mailing address

13521 S Park Presidio Way Unit 1402
Draper, UT 84020-1989
Phone (704) 886-4075

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
11285653-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Confidence Co., the PLLC Clinical CurrentSince Sep 17, 2023 Accepting new patients
Kaizen Center for Mental Health PLLC Clinical PastSince Jul 9, 2023 Accepting new patients

Locations

10808 S River Front Pkwy
Ste 352
South Jordan, UT 84095
Phone (704) 886-4075

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1396489480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13521 S PARK PRESIDIO WAY UNIT 1402",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840201989",
            "telephone_number": "704-886-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10808 S RIVER FRONT PKWY STE 352",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840956100",
            "telephone_number": "704-886-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATES",
        "first_name": "JOSHUA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-25",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "11285653-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.