Individual provider Active NPI

Christina Jeanne Jeffery Cackler, LCSW, MPH

  • Clinical Social Worker
  • West Jordan, UT
National Provider Identifier
1528515798
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10999106-3501 Issued in UT
Practice address
7533 S Center View CT Ste N
West Jordan, UT 84084-5526
Phone
(801) 228-0927
NPI assigned
Sep 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Social Worker 104100000X ASW60571 CA
Clinical Social Worker 1041C0700X 10999106-3501 UT Primary

Addresses

Primary practice location

7533 S Center View CT Ste N
West Jordan, UT 84084-5526

Mailing address

7533 S Center View CT Ste N
West Jordan, UT 84084-5526
Phone (801) 228-0927

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL ccackler315985@direct.med.utah.edu Direct University of Utah

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW60571CAMDSocial Worker
10999106-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Upstream, PLLC Current Accepting new patients

Locations

4055 S 700 E
Millcreek, UT 84107
Phone (801) 228-0927

7533 S Center View Ct
West Jordan, UT 84084
Phone (385) 539-2077

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1528515798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7533 S CENTER VIEW CT STE N",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840845526",
            "telephone_number": "801-228-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7533 S CENTER VIEW CT STE N",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840845526",
            "telephone_number": "801-228-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACKLER",
        "first_name": "CHRISTINA",
        "middle_name": "JEANNE JEFFERY",
        "credential": "LCSW, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW60571",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "10999106-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ccackler315985@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; 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.