Individual provider Active NPI

Chandler Eads

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1578296604
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12808152-3501 Issued in UT
Practice address
1020 S Main St
Salt Lake City, UT 84101-3176
Phone
(888) 949-4864
NPI assigned
Jul 6, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 12808152-3501 UT Primary

Addresses

Primary practice location

1020 S Main St
Salt Lake City, UT 84101-3176

Mailing address

3725 W 4100 S Ste 201
West Valley City, UT 84120-5411
Phone (888) 949-4864

Other practice location 1

4460 S Highland Dr
Salt Lake City, UT 84124-3543
Phone (888) 949-4864

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241126004021 UT Practitioner - Clinical Social Worker 3870028988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Behavioral Health IncorporatedGroup PAC ID 0042121196, 84 clinicians

Practice addresses (Care Compare)

1020 S Main St
Salt Lake City, UT 84101-3176
Phone (801) 539-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Behavioral Health Incorporated Clinical CurrentSince Nov 8, 2024 Accepting new patients
Valley Mental Health Incorporated Social Worker Current Accepting new patients

Locations

4460 S Highland Dr
Slc, UT 84124
Phone (801) 263-7101

4460 S Highland Dr
Ste 230
Slc, UT 84124
Phone (801) 263-7227

1020 S Main St
Slc, UT 84101
Phone (801) 536-6500

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1578296604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 W 4100 S STE 201",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841205411",
            "telephone_number": "888-949-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S MAIN ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841013176",
            "telephone_number": "888-949-4864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4460 S Highland Dr",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841243543",
            "country_code": "US",
            "telephone_number": "888-949-4864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EADS",
        "first_name": "CHANDLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-06",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "12808152-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.