Active NPI
Jaylynn Deon Olsen, LCSW
- Clinical Social Worker
- Salt Lake City, UT
National Provider Identifier
1447716493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 9733876-3501
- Practice address
- 100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103 - NPI assigned
- Feb 14, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 9733876-3501 | UT | Primary |
Addresses
Primary practice location
100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Mailing address
1578 E Glen Arbor St
Salt Lake City, UT 84105-3813
Phone (435) 851-4693
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 18, 2024 through Jan 18, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9733876-3501 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550102400000",
"number": "1447716493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1578 E GLEN ARBOR ST",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841053813",
"telephone_number": "435-851-4693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSEN",
"first_name": "JAYLYNN",
"middle_name": "DEON",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-14",
"last_updated": "2019-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "9733876-3501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; 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.