Individual provider Active NPI

Michelle H Greene, LCSW

  • Clinical Social Worker
  • Sandy, UT
National Provider Identifier
1508971276
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
62218503502 Issued in UT
Practice address
11075 S State St Ste 16
Sandy, UT 84070-5196
Phone
(801) 350-1671
Fax
(801) 446-6511
NPI assigned
Aug 20, 2006
Last updated
Sep 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 62218503502 UT Primary

Addresses

Primary practice location

11075 S State St Ste 16
Sandy, UT 84070-5196

Mailing address

PO Box 1292
Midway, UT 84049-1292
Phone (801) 350-1671

Other practice location 1

425 E 1200 S Ste L4
Heber City, UT 84032-3943
Phone (435) 962-9335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120411000840 UT Practitioner - Clinical Social Worker 7315108735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Utah School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11075 S State St
Suite 16
Sandy, UT 84070-5196
Phone (801) 350-1671

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62218503502UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Synergism Counseling, LLC CurrentSince Dec 18, 2011 Accepting new patients

Locations

425 E 1200 S
Ste L4
Heber City, UT 84032
Phone (435) 513-1500

11075 S State St
Ste 16
Sandy, UT 84070
Phone (801) 350-1671

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1508971276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1292",
            "city": "MIDWAY",
            "state": "UT",
            "postal_code": "840491292",
            "telephone_number": "801-350-1671",
            "fax_number": "801-446-6511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11075 S STATE ST STE 16",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840705196",
            "telephone_number": "801-350-1671",
            "fax_number": "801-446-6511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 E 1200 S Ste L4",
            "address_purpose": "LOCATION",
            "city": "Heber City",
            "state": "UT",
            "postal_code": "840323943",
            "country_code": "US",
            "telephone_number": "435-962-9335",
            "fax_number": "801-446-6511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENE",
        "first_name": "MICHELLE",
        "middle_name": "H",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "62218503502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

Verify at the official NPI Registry.