Individual provider Active NPI

Angela De Giorgio, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1417404088
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10979280-3501 Issued in UT
Practice address
5383 S 900 E Ste 103
Salt Lake City, UT 84117-7266
Phone
(801) 872-5516
Fax
(801) 212-9942
NPI assigned
Sep 1, 2016
Last updated
Aug 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10979280-3502 UT
Clinical Social Worker 1041C0700X 10979280-3501 UT Primary

Addresses

Primary practice location

5383 S 900 E Ste 103
Salt Lake City, UT 84117-7266

Mailing address

934 S Main St
Layton, UT 84041-7135
Phone (801) 336-1845

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
I20220622001251 UT Practitioner - Clinical Social Worker 9739568726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Davis Behavioral Health IncGroup PAC ID 7416861919, 61 clinicians

Practice addresses (Care Compare)

2250 N Robins Dr
Layton, UT 84041-1140
Phone 8017737060482

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10979280-3502UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Davis Behavioral Health Inc CurrentSince Feb 9, 2024 Accepting new patients
Davis Behavioral Health Inc Clinical CurrentSince Feb 9, 2024 Accepting new patients

Locations

2250 N Robins Dr
Layton, UT 84041
Phone (801) 779-3001

2250 N Robins Dr
Bldg E
Layton, UT 84041

934 S Main St
Layton, UT 84041
Phone (801) 336-1845

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.angeladegiorgio@154909.advancedmd-direct.com

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": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1417404088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 S MAIN ST",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417135",
            "telephone_number": "801-336-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5383 S 900 E STE 103",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841177266",
            "telephone_number": "801-872-5516",
            "fax_number": "801-212-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE GIORGIO",
        "first_name": "ANGELA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "10979280-3502",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "10979280-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.