Jerry Marvin Utt, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C000778 Issued in NC

Practice address

301 East Parker Street
Kings Mountain, NC 28086

Phone

(704) 730-1591

NPI assigned

Nov 29, 2007

Last updated

Nov 29, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 NC

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, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Harris Counseling and Consulting LLCGroup PAC ID 9436507571, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Harris Counseling and Consulting LLC

  • Clinical Social Worker
  • Lincolnton, NC
  • NPI 1003688326
  Medicare reassignment Care Compare group NPD
• Restoration Concepts, Inc.

  • Community/Behavioral Health Agency
  • Shelby, NC
  • NPI 1811031107
  NPD (past)

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1659553832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 EAST PARKER STREET",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "28086",
            "telephone_number": "704-730-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 EAST PARKER STREET",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "28086",
            "telephone_number": "704-730-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTT",
        "first_name": "JERRY",
        "middle_name": "MARVIN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-29",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C000778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire Elizabeth Thombs, LCSW
• Everette B Thombs Sr., MD
• Lucas Adam Traylor, PHARM. D.
• Deborah B Trivett, LMBT, MMP
• Deanna Lee Unnasch, LMBT
• Yvonne Andrea Valencia, FNP-C
• Chasity Latreece Vargas, DNP FNP-BC
• Neenah Jolly Vaughn, NP
• Kayla Vitali
• Brittany Ashton Volovar

• Clinical Social Worker in Kings Mountain, NC
• Providers in Kings Mountain, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.
• 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.