Isaac Michael Phillips, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6613419-3501 Issued in UT

Practice address

7745 S 2325 E
Cottonwood Heights, UT 84121-5668

Phone

(801) 450-2798

NPI assigned

Feb 17, 2012

Last updated

Feb 17, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2017 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Equinox Counseling Services LLC

  • Clinical Social Worker
  • Holladay, UT
  • NPI 1043577877
  NPD (past) Authorized official

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

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1558634725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7745 S 2325 E",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841215668",
            "telephone_number": "801-450-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7745 S 2325 E",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841215668",
            "telephone_number": "801-450-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "ISAAC",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-17",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "6613419-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyanna Petty-Dailey
• Grace Petty
• Teri Phelps
• Alexa Phillips
• Andrea Dae Allen Phillips, LCSW
• Pinnacle Point Counseling, LLC
• Alexis Daniels Player
• Broderick Pollmann
• Alek Ponce
• Ifan Cassandra Poulsen

• Clinical Social Worker in Cottonwood Heights, UT
• Providers in Cottonwood Heights, 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 Feb 17, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.