NPIMap

Organization Active NPI

Trauma Solutions Counseling, PLLC

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1669068771
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
TRAUMA SOLUTIONS COUNSELING, PLLC
Practice address
1174 E Graystone Way Ste 3
Salt Lake City, UT 84106-2671
Phone
(385) 200-0786
Fax
(385) 415-0567
NPI assigned
Dec 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Authorized official

Name
Erick John Panike, LCSWNPI 1639684566
Title
Owner
Phone
(385) 200-0786

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1174 E Graystone Way Ste 3
Salt Lake City, UT 84106-2671

Mailing address

1174 E Graystone Way Ste 3
Salt Lake City, UT 84106-2671
Phone (385) 200-0786

Other names 1

  • Trauma Solutions Counseling Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210108000486 UT Part B Supplier - Clinic/Group Practice 2567875701 Receives reassigned benefits from 1 practitioner
Practice locations: Salt Lake City, UT

National Provider Directory

National Provider Directory

Locations

1174 E Graystone Way
Ste 3
Salt Lake City, UT 84106
Phone (385) 200-0786

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609113600000",
    "number": "1669068771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 E GRAYSTONE WAY STE 3",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062671",
            "telephone_number": "385-200-0786",
            "fax_number": "385-415-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 E GRAYSTONE WAY STE 3",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062671",
            "telephone_number": "385-200-0786",
            "fax_number": "385-415-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAUMA SOLUTIONS COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A",
        "authorized_official_last_name": "PANIKE",
        "authorized_official_first_name": "ERICK",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "385-200-0786",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trauma Solutions Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Trauma Solutions Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.