Samantha Fay Guillory, CSW – Clinical Social Worker

Key facts

NPI: 1568065407
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: 11934838 (UT)
Practice address: 11260 S River Heights Drive
South Jordan, UT 84095
Phone: (801) 298-2000
NPI assigned: Nov 20, 2020
Sex: Female
Sole proprietor: Yes

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.

Complete Evaluations LLC Psychologist · Payson, UT · NPI 1962994590

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
11934838	UT	MD	Clinical Social Worker

Practice roles

Organization	Specialty	Status	New patients
Complete Evaluations LLC		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	11934838	UT	Yes

Addresses

Primary practice location

11260 S River Heights Drive
South Jordan, UT 84095

Mailing address

902 N 400 E
Nephi, UT 84648-1021
Phone (435) 287-5036

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 20, 2020.

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1568065407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 N 400 E",
            "city": "NEPHI",
            "state": "UT",
            "postal_code": "846481021",
            "telephone_number": "435-287-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11260 S RIVER HEIGHTS DRIVE",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84095",
            "telephone_number": "801-298-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLORY",
        "first_name": "SAMANTHA",
        "middle_name": "FAY",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "11934838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

All providers in South Jordan, UT · Clinical Social Worker in Utah

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.