Active NPI
Susan Keene, L.C.S.W.
- Clinical Social Worker
- Salt Lake City, UT
National Provider Identifier
1568433811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3123283501
- Practice address
- 443 S 600 E
Salt Lake City, UT 84102-2708 - Phone
- (801) 538-2057
- NPI assigned
- Jan 26, 2006
- Sex
- Female
- 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 | 3123283501 | UT | Primary |
Addresses
Primary practice location
443 S 600 E
Salt Lake City, UT 84102-2708
Mailing address
611 S 1300 E
Salt Lake City, UT 84102-3206
Phone (801) 538-2057
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003117003 | Other | UT | RAILROAD 'CARE RCAR |
| Q07205 | Other | UT | ICAR MEDICARE ADVANTAGE |
| 740409 | Other | UT | U002 DESERET MUTUAL |
| 942938348KE1 | Other | UT | U003 EDUCATRS MUTUAL |
| 107011057101 | Other | UT | U006 INTRMT 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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310083200000",
"number": "1568433811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 S 1300 E",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841023206",
"telephone_number": "801-538-2057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "443 S 600 E",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841022708",
"telephone_number": "801-538-2057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEENE",
"first_name": "SUSAN",
"name_prefix": "Ms.",
"credential": "L.C.S.W.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-26",
"last_updated": "2011-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "3123283501",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD 'CARE RCAR",
"identifier": "003117003",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ICAR MEDICARE ADVANTAGE",
"identifier": "Q07205",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U002 DESERET MUTUAL",
"identifier": "740409",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U003 EDUCATRS MUTUAL",
"identifier": "942938348KE1",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U006 INTRMT HEALTH CARE",
"identifier": "107011057101",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.