Individual provider Active NPI

Lisa L Boice, LCSW

  • Clinical Social Worker
  • Millcreek, UT
National Provider Identifier
1437176146
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3158523501 Issued in UT
Practice address
4064 S Highland Dr
Millcreek, UT 84124-1617
Phone
(801) 501-4350
NPI assigned
Jul 17, 2006
Last updated
Nov 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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 3158523501 UT Primary

Addresses

Primary practice location

4064 S Highland Dr
Millcreek, UT 84124-1617

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 501-4350

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
I20040108000826 UT Practitioner - Clinical Social Worker 6103725072 Practice locations: Millcreek, UT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4064 S Highland Dr
Millcreek, UT 84124-1617
Phone (385) 290-9852

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3158523501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa Boice LCSW Clinical CurrentSince Sep 11, 2022 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

4064 S Highland Dr
Salt Lake City, UT 84124
Phone (385) 290-9852

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1437176146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-501-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4064 S HIGHLAND DR",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841241617",
            "telephone_number": "801-501-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOICE",
        "first_name": "LISA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "3158523501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millcreek, UT

Sources for this page

Verify at the official NPI Registry.