Michaela Sofia Higashiyama, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14235706-3501 Issued in UT

Practice address

2850 N 2000 W Ste 101
Farr West, UT 84404-9230

Phone

(801) 528-5095

Fax

(801) 528-5094

NPI assigned

Jul 26, 2024

Last updated

Jul 29, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Michaela Sofia Jendrysik Former name

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

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Revere Health PCGroup PAC ID 7517868508, 407 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Revere Health PC

  dba Revere Health

  • Multi-Specialty Clinic/Center
  • Provo, UT
  • NPI 1093764805
  Medicare reassignment Care Compare group NPD
• Revere Health PC

  dba Revere Health

  • Multi-Specialty Clinic/Center
  • Spanish Fork, UT
  • NPI 1851142285
  NPD

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

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1629806955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "ATTN CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 N 2000 W STE 101",
            "city": "FARR WEST",
            "state": "UT",
            "postal_code": "844049230",
            "telephone_number": "801-528-5095",
            "fax_number": "801-528-5094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1205 1st Ave NW",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594042202",
            "country_code": "US",
            "telephone_number": "801-600-5774",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2850 N 2000 W Ste 201",
            "address_purpose": "LOCATION",
            "city": "Farr West",
            "state": "UT",
            "postal_code": "844049230",
            "country_code": "US",
            "telephone_number": "801-866-0170",
            "fax_number": "801-866-0169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIGASHIYAMA",
        "first_name": "MICHAELA",
        "middle_name": "SOFIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-26",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-72295",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "14235706-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAELA",
            "last_name": "JENDRYSIK",
            "middle_name": "SOFIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kiara Hamada
• Rishel Hartshorn
• Becky Lyn Heileson, PMHNP
• Colleen Henies
• Trevor Joseph Heywood
• Kaiya Hoki
• Dean Allen Holloway, IDMT
• Cameron Keith Hoskisson
• Trinity Maire Hughes-Berger
• Shanalyn Hunsaker, LMFT

• Clinical Social Worker in Farr West, UT
• Providers in Farr West, 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 29, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.