Fiddle Creek Counseling

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

FIDDLE CREEK COUNSELING

Practice address

475 N 300 W Ste 16
Kaysville, UT 84037-3110

Phone

(208) 547-7762

NPI assigned

Jan 3, 2024

Organization subpart

No

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

Authorized official

Name

Jaclyn RandolphNPI 1417610189

Title

LCSW

Phone

(208) 547-7762

Specialties & licenses 1

Addresses

Practitioners 1

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

• Jaclyn Randolph

  • Clinical Social Worker
  • Kaysville, UT
  • NPI 1417610189
  NPD Authorized official

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1649040536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 N 300 W STE 16",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840373110",
            "telephone_number": "208-547-7762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 N 300 W STE 16",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840373110",
            "telephone_number": "208-547-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIDDLE CREEK COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "RANDOLPH",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "208-547-7762"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Kaysville, UT
• Providers in Kaysville, 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 Jan 3, 2024; 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.