Jenna Lee Shirley

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9455954-3501 Issued in UT

Practice address

1290 S 500 W Ste 300
Woods Cross, UT 84010-8104

Phone

(801) 734-0581

NPI assigned

Mar 2, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Jenna Shirley Counseling

  • Community/Behavioral Health Agency
  • Woods Cross, UT
  • NPI 1376116764
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1548568371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3983 S 855 E",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841072366",
            "telephone_number": "801-734-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 S 500 W STE 300",
            "city": "WOODS CROSS",
            "state": "UT",
            "postal_code": "840108104",
            "telephone_number": "801-734-0581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 N 200 W",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846011677",
            "country_code": "US",
            "telephone_number": "801-373-4760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3983 S 855 E",
            "address_purpose": "LOCATION",
            "city": "Millcreek",
            "state": "UT",
            "postal_code": "841072366",
            "country_code": "US",
            "telephone_number": "801-734-0581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "JENNA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-02",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "9455954-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Senior Health LLC
• Senior Health LLC
• Senior Health LLC
• Marissa Marian Shaver, MSW
• Elizabeth Shipman, LMFT
• David Smith, PTA
• Smiths Food & Drug Centers Inc
• Sol Recovery Community, Inc.
• Sol Recovery Community, Inc.
• Spectrum of Care LLC

• Clinical Social Worker in Woods Cross, UT
• Providers in Woods Cross, 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 Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.