Tracy Bert Anderson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1349383501 Issued in UT

Practice address

5689 S Redwood Rd # 30
Salt Lake City, UT 84123-5322

Phone

(801) 359-4884

Fax

(801) 532-1052

NPI assigned

Mar 13, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568595106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5689 S REDWOOD RD # 30",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841235322",
            "telephone_number": "801-359-4884",
            "fax_number": "801-532-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5689 S REDWOOD RD # 30",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841235322",
            "telephone_number": "801-359-4884",
            "fax_number": "801-532-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TRACY",
        "middle_name": "BERT",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "1349383501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Anderson, RBT
• Thomas Howard Anderson, MD
• Thomas W Anderson, DC
• Tiffany D Anderson
• Tracie Anderson, BSN
• Tristan Anderson
• Zachary Anderson, PHARM.D., BCACP
• Aaron Anderstrom
• Akina Anderstrom
• Barry J Anderton, MD

• Clinical Social Worker in Salt Lake City, UT
• Providers in Salt Lake City, 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 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.