Theresa Schubach, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6316503-3502 Issued in UT

Practice address

562 E Fort Union Blvd
Midvale, UT 84047-2245

Phone

(801) 243-7369

NPI assigned

Aug 31, 2009

Sex

Female

Sole proprietor

Yes

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)

Enrolled

State licenses

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1497988976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7999 FARM CREEK CIR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840936288",
            "telephone_number": "801-243-7369",
            "fax_number": "801-944-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 E FORT UNION BLVD",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472245",
            "telephone_number": "801-243-7369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3098 S Highland Dr",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841063085",
            "country_code": "US",
            "telephone_number": "801-243-7369",
            "fax_number": "801-944-9314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHUBACH",
        "first_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "6316503-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Midvale, UT
• Providers in Midvale, 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 Mar 17, 2018; 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.