Individual provider Active NPI

Gabrielle M. Kouris

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1669093043
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9879681-3501 Issued in UT
Practice address
2872 S Highland Dr Apt Suite
Salt Lake City, UT 84106-3147
Phone
(801) 485-8051
NPI assigned
Apr 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 9879681-3501 UT Primary

Addresses

Primary practice location

2872 S Highland Dr Apt Suite
Salt Lake City, UT 84106-3147

Mailing address

7533 S Center View CT Ste 4741
West Jordan, UT 84084-5526
Phone (385) 275-6468

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9879681-3501UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1669093043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7533 S CENTER VIEW CT STE 4741",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840845526",
            "telephone_number": "385-275-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2872 S HIGHLAND DR APT SUITE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063147",
            "telephone_number": "801-485-8051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOURIS",
        "first_name": "GABRIELLE",
        "middle_name": "M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "9879681-3501",
            "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 Jan 30, 2025; 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.