Melanie Elder, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6565316-3501 Issued in UT

Practice address

338 W 300 N Ste 1
Hyde Park, UT 84318-4044

Phone

(435) 774-4113

Fax

(435) 535-3197

NPI assigned

Jun 11, 2010

Sex

Female

Sole proprietor

No

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.

• Bear River Mental Health Services Inc

  • Mental Health Counselor
  • Logan, UT
  • NPI 1285736553
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2020 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 9, 2023.

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1447571575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 W 300 N STE 1",
            "city": "HYDE PARK",
            "state": "UT",
            "postal_code": "843184044",
            "telephone_number": "435-774-4113",
            "fax_number": "435-535-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 W 300 N STE 1",
            "city": "HYDE PARK",
            "state": "UT",
            "postal_code": "843184044",
            "telephone_number": "435-774-4113",
            "fax_number": "435-535-3197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER",
        "first_name": "MELANIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-11",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "6565316-3502",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "6565316-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Dee Carlson, D.C.
• Chiro-Active Inc.
• Melanie Christensen
• Cheryl Lynn Coleman, MA, RD, LD
• Complete Fitness Innovations
• Epic Eye Health PLLC
• Eva Alexandria Fallon, ABA
• Avary Joy Farnsworth
• Jessica Fecteau
• Jace H Ferguson, D.C.

• All providers in Hyde Park, UT
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.