Individual provider Active NPI

Cailey Michele Green

  • School Social Worker
  • South Salt Lake, UT
National Provider Identifier
1487177606
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
10107124-3502 Issued in UT
Practice address
2500 S State St
South Salt Lake, UT 84115-3164
Phone
(385) 646-8835
NPI assigned
Jul 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 10107124-3502 UT Primary

Addresses

Primary practice location

2500 S State St
South Salt Lake, UT 84115-3164

Mailing address

5243 W 6600 S
West Jordan, UT 84081-4413
Phone (801) 635-9904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10107124-3502UTMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1487177606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5243 W 6600 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840814413",
            "telephone_number": "801-635-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S STATE ST",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841153164",
            "telephone_number": "385-646-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CAILEY",
        "middle_name": "MICHELE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "UT",
            "license": "10107124-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Salt Lake, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.