Individual provider Active NPI

Marian Kaye Knudson, LCSW

  • Clinical Social Worker
  • Murray, UT
National Provider Identifier
1538131461
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
137390-3501 Issued in UT
Practice address
5802 S 900 E # 5
Murray, UT 84121-1644
Phone
(801) 671-3894
NPI assigned
Feb 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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 137390-3501 UT Primary

Addresses

Primary practice location

5802 S 900 E # 5
Murray, UT 84121-1644

Mailing address

5802 S 900 E # 5
Murray, UT 84121-1644
Phone (801) 671-3894

Other identifiers 1

IdentifierTypeStateIssuer
13739035000001OtherUTBLUE CROSS

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
137390-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Mental Health Incorporated Clinical Past Accepting new patients

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": "1139011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1538131461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5802 S 900 E # 5",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841211644",
            "telephone_number": "801-671-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5802 S 900 E # 5",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841211644",
            "telephone_number": "801-671-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUDSON",
        "first_name": "MARIAN",
        "middle_name": "KAYE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-04",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "137390-3501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "13739035000001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.