Individual provider Active NPI

Louthilia Mose, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1407523079
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7991152-3501 Issued in UT
Practice address
2687 E Promenade Dr
Salt Lake City, UT 84121-4035
Phone
(801) 645-3996
NPI assigned
Aug 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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 7991152-3501 UT Primary

Addresses

Primary practice location

2687 E Promenade Dr
Salt Lake City, UT 84121-4035

Mailing address

2687 E Promenade Dr
Salt Lake City, UT 84121-4035
Phone (801) 645-3996

Other practice location 1

5171 S Cottonwood St Ste 210
Murray, UT 84107-5718
Phone (801) 507-3380

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
I20250723004374 UT Practitioner - Clinical Social Worker 3173039294 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7991152-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince May 30, 2025 Accepting new patients
Ihc Health Services, Inc. CurrentSince May 30, 2025 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

5171 S Cottonwood St
Ste 210
Salt Lake City, UT 84107

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1407523079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2687 E PROMENADE DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841214035",
            "telephone_number": "801-645-3996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2687 E PROMENADE DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841214035",
            "telephone_number": "801-645-3996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5171 S Cottonwood St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841075718",
            "country_code": "US",
            "telephone_number": "801-507-3380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSE",
        "first_name": "LOUTHILIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "7991152-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.