Organization Active NPI

SJV, Inc. a Professional Corporation

  • Community/Behavioral Health Agency
  • Salt Lake City, UT
National Provider Identifier
1568529188
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
134414-3501 Issued in UT
Legal business name
SJV, INC. A PROFESSIONAL CORPORATION
Practice address
4505 Wasatch Blvd
Suite 320
Salt Lake City, UT 84124-4709
Phone
(801) 277-8100
Fax
(801) 277-8800
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Authorized official

Name
Mr. Steve Varechok, LCSWNPI 1376690610
Title
Licensed Clinical Social Worker
Phone
(801) 277-8100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 134414-3501 UT Primary

Addresses

Primary practice location

4505 Wasatch Blvd
Suite 320
Salt Lake City, UT 84124-4709

Mailing address

4505 Wasatch Blvd
Suite 320
Salt Lake City, UT 84124-4709
Phone (801) 277-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080320000112 UT Part B Supplier - Clinic/Group Practice 2860578630 Receives reassigned benefits from 1 practitioner
Practice locations: Salt Lake City, UT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1568529188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 WASATCH BLVD",
            "address_2": "SUITE 320",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841244709",
            "telephone_number": "801-277-8100",
            "fax_number": "801-277-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 WASATCH BLVD",
            "address_2": "SUITE 320",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841244709",
            "telephone_number": "801-277-8100",
            "fax_number": "801-277-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SJV, INC. A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "VARECHOK",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "801-277-8100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "UT",
            "license": "134414-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.