Audrey Mulliken Duross, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6727018-3502 Issued in UT

Practice address

2720 Homestead Rd Ste 40
Park City, UT 84098-4885

Phone

(801) 910-7193

NPI assigned

Oct 16, 2007

Last updated

Dec 7, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1467641480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 LOWER EVERGREEN DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985254",
            "telephone_number": "801-910-7193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 HOMESTEAD RD STE 40",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840984885",
            "telephone_number": "801-910-7193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUROSS",
        "first_name": "AUDREY",
        "middle_name": "MULLIKEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-16",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "6727018-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisabeth Nichole Dreyer, L.AC.
• Rita Kartini Drummond, O.D.
• Jennifer P Duffin, CMHC
• Belinda Duncan, PHARMD
• Charles Dupaix, PA-C
• Tracey Dwyer, LMFT
• Shannon Jennings Early, DPT
• East West Health Park City
• Madeline Kate Ekins, PT, DPT, CSCS
• Elevated Mental Health LLC

• Clinical Social Worker in Park City, UT
• Providers in Park 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 Dec 7, 2021; 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.