Kendall Kristanne Paxman-Black, MSW, CSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10697151-3502 Issued in UT

Practice address

352 S Denver St Ste 350
Salt Lake City, UT 84111-3059

Phone

(801) 521-4227

Fax

(801) 359-0777

NPI assigned

Jun 3, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Charles L Diviney III MC LPC NCC LLC

  • Professional Counselor
  • SLC, UT
  • NPI 1235447772

  Clinical

  NPD (past)

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1407697816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3872",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103872",
            "telephone_number": "801-521-4227",
            "fax_number": "801-359-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 S DENVER ST STE 350",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841113059",
            "telephone_number": "801-521-4227",
            "fax_number": "801-359-0777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "370 S 500 E Ste 209",
            "address_purpose": "LOCATION",
            "city": "Clearfield",
            "state": "UT",
            "postal_code": "840154063",
            "country_code": "US",
            "telephone_number": "801-521-4227",
            "fax_number": "801-359-0777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAXMAN-BLACK",
        "first_name": "KENDALL",
        "middle_name": "KRISTANNE",
        "name_prefix": "Ms.",
        "credential": "MSW, CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "10697151-3502",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "10697151-3502",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "10697151-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eryka Pawlak, APRN
• Natalie O. Pawlak, MD
• Jacob P Pawlovich
• Celia Pawlowich, LCSW
• Allison Christine Pawlus, RN
• Heidi Karen Paxman
• Paxton Loving Home Care LLC
• Macy Richelle Paxton
• Richard Wendell Paxton, DDS
• Sergio Payan

• Clinical Social Worker in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.