Individual provider Active NPI

Michele R Decremer, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1407057797
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6619555-3502 Issued in UT
Practice address
1141 E 3900 S
A-170
Salt Lake City, UT 84124-1215
Phone
(801) 284-4990
NPI assigned
May 31, 2007
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6619555-3502UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Mental Health Incorporated Clinical Past Accepting new patients
Valley Behavioral Health Incorporated Clinical Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6619555-3502 UT Primary

Addresses

NPPES NPI Registry

Primary practice location

1141 E 3900 S
A-170
Salt Lake City, UT 84124-1215

Mailing address

2220 Union Ave
Memphis, TN 38104-4315
Phone (901) 567-3554

Other names 1

NPPES NPI Registry
  • Michele Rands Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 11, 2016.

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1407057797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381044315",
            "telephone_number": "901-567-3554",
            "fax_number": "901-567-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 E 3900 S",
            "address_2": "A-170",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241215",
            "telephone_number": "801-284-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECREMER",
        "first_name": "MICHELE",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "6619555-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "RANDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jan 11, 2016; 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.