Individual provider Active NPI

Sarah Mohanavilasam

  • Clinical Social Worker
  • Layton, UT
National Provider Identifier
1396567186
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13989909-3502 Issued in UT
Practice address
748 S 825 E
Layton, UT 84041-4390
Phone
(352) 256-2560
NPI assigned
Oct 31, 2024
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 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 13989909-3502 UT Primary

Addresses

Primary practice location

748 S 825 E
Layton, UT 84041-4390

Mailing address

748 S 825 E
Layton, UT 84041-4390

Other names 1

  • Sarah Suiter Former name

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
13989909-3502UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Alternative Healing-Trauma and Psychedelic Integration Clinic CurrentSince Nov 3, 2024 Accepting new patients
Juniper Ridge Therapy PLLC Current Accepting new patients

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": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1396567186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "748 S 825 E",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 S 825 E",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414390",
            "telephone_number": "352-256-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHANAVILASAM",
        "first_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "13989909-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "SUITER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.