Individual provider Active NPI

Elizabeth Kindred

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1619313962
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L7915 Issued in OR
Practice address
4190 S Highland Dr Ste 108
Salt Lake City, UT 84124-2600
Phone
(801) 930-0653
NPI assigned
May 14, 2013
Last updated
Oct 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L7915 OR Primary

Addresses

Primary practice location

4190 S Highland Dr Ste 108
Salt Lake City, UT 84124-2600

Mailing address

63357 Britta St Apt 4
Bend, OR 97703-6679
Phone (801) 930-0653

Other practice location 1

2542 NE Courtney Dr
Bend, OR 97701
Phone (541) 706-2768

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": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1619313962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63357 BRITTA ST APT 4",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977036679",
            "telephone_number": "801-930-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 S HIGHLAND DR STE 108",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242600",
            "telephone_number": "801-930-0653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2542 NE Courtney Dr",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "97701",
            "country_code": "US",
            "telephone_number": "541-706-2768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINDRED",
        "first_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-14",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7915",
            "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 Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.