Active NPI
Mathea Anderson, LCSW
- Clinical Social Worker
- Heber City, UT
National Provider Identifier
1427179134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 122213-3501
- Practice address
- 175 N Main St
Heber City, UT 84032-1606 - Phone
- (435) 657-9631
- Fax
- (435) 657-9631
- NPI assigned
- Apr 2, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 122213-3501 | UT | Primary |
Addresses
Primary practice location
175 N Main St
Heber City, UT 84032-1606
Mailing address
175 North Main
Heber City, UT 84032
Phone (435) 657-9631
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 122213-3501 | UT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brian J Taracena PSYD PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Heber City, UT
- NPI 1427123082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1427179134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 NORTH MAIN",
"city": "HEBER CITY",
"state": "UT",
"postal_code": "84032",
"telephone_number": "435-657-9631",
"fax_number": "435-657-9631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 N MAIN ST",
"city": "HEBER CITY",
"state": "UT",
"postal_code": "840321606",
"telephone_number": "435-657-9631",
"fax_number": "435-657-9631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "MATHEA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "122213-3501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Heber City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.