Active NPI
Robert S Gorelik, LCSW
- Clinical Social Worker
- Park City, UT
National Provider Identifier
1548345408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1373693501
- Practice address
- 8834 Gorgoza Dr
Park City, UT 84098-4734 - Phone
- (435) 645-9336
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1373693501 | UT | Primary |
Addresses
Primary practice location
8834 Gorgoza Dr
Park City, UT 84098-4734
Mailing address
8834 Gorgoza Dr
Park City, UT 84098-4734
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 292735 | Other | UT | DESERET MUTUAL INSURANCE |
| 942938348GO1 | Other | UT | EDUCATORS MUTUAL |
| 107000923101 | Other | UT | INTERMOUNTIAN HEALTH CARE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1373693501 | UT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Behavioral 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- West Valley City, UT
- NPI 1932166980
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208908800000",
"number": "1548345408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8834 GORGOZA DR",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840984734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8834 GORGOZA DR",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840984734",
"telephone_number": "435-645-9336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORELIK",
"first_name": "ROBERT",
"middle_name": "S",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2008-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "1373693501",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DESERET MUTUAL INSURANCE",
"identifier": "292735",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EDUCATORS MUTUAL",
"identifier": "942938348GO1",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERMOUNTIAN HEALTH CARE",
"identifier": "107000923101",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Park City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.