Individual provider Active NPI

Carolshene Powell

  • Social Worker
  • Price, UT
National Provider Identifier
1407138076
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
5617259-3503 Issued in UT
Practice address
105 West 100 North
Price, UT 84501-3102
Phone
(435) 637-2358
Fax
(435) 637-9141
NPI assigned
Sep 9, 2011
Last updated
Sep 16, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 5617259-3503 UT Primary

Addresses

Primary practice location

105 West 100 North
Price, UT 84501-3102

Mailing address

105 West 100 North
PO Box 867
Price, UT 84501
Phone (435) 637-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240716003330 UT Practitioner - Mental Health Counselor 3678963220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

575 E 100
Price, UT 84501-3102
Phone (435) 637-2358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5617259-3503UTMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Four Corners Community Behavioral Health Inc CurrentSince Dec 6, 2021 Accepting new patients
Four Corners Community Behavioral Health, Inc. CurrentSince Jun 4, 2024 Accepting new patients

Locations

105 W 100 N
Price, UT 84501

575 E 1st S
Price, UT 84501
Phone (435) 637-2358

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": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1407138076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WEST 100 NORTH",
            "address_2": "PO BOX 867",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "84501",
            "telephone_number": "435-637-7200",
            "fax_number": "435-637-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WEST 100 NORTH",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845013102",
            "telephone_number": "435-637-2358",
            "fax_number": "435-637-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "CAROLSHENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-09",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "5617259-3503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Price, UT

Sources for this page

Verify at the official NPI Registry.