Sydney Rebekah Dawson Ballstaedt, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12917073-3501 Issued in UT

Practice address

344 E 100 S
Salt Lake City, UT 84111-1700

Phone

(801) 322-3222

NPI assigned

Jul 22, 2020

Last updated

May 10, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Sydney Rebekah Dawson Former name

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sydney Ballstaedt Therapy LLC

  • Clinical Social Worker
  • Lehi, UT
  • NPI 1760355002
  NPD Authorized official

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1437767787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 N STATE ST",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840572025",
            "telephone_number": "435-922-6471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 E 100 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841111700",
            "telephone_number": "801-322-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLSTAEDT",
        "first_name": "SYDNEY",
        "middle_name": "REBEKAH DAWSON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-22",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "12917073-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SYDNEY",
            "last_name": "DAWSON",
            "middle_name": "REBEKAH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Barbara Sue Balliette
• Shannon Ballinger, DPT
• Carol Ann Ballou, PHD
• Nathan Balls
• Travis Balls
• Maria Pia Balmaceda Nieto, MD
• Kami Balmforth, LCSW
• Sara Anne Balte
• Marie Dufresne Bambo, PT
• Andrew Bambrough

• 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 May 10, 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.