Matthew Joseph Edrington

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10834612-3501 Issued in UT

Practice address

1515 N 400 E Ste 104
North Logan, UT 84341-7595

Phone

(435) 755-6061

Fax

(435) 755-6091

NPI assigned

Nov 26, 2012

Last updated

Nov 22, 2022By 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 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Central Utah Counseling Center

  • Multi-Specialty Clinic/Center
  • Ephraim, UT
  • NPI 1629421524
  NPD (past)
• Ora Counseling

  • Multi-Specialty Clinic/Center
  • Logan, UT
  • NPI 1043810047
  NPD (past)
• Medical Imaging Associates of Idaho Falls, Inc

  • Diagnostic Radiology Physician
  • Pocatello, ID
  • NPI 1740225531
  NPD (past)

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1669716924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 W 100 N STE 210",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843329826",
            "telephone_number": "435-755-6061",
            "fax_number": "435-994-8362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N 400 E STE 104",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843417595",
            "telephone_number": "435-755-6061",
            "fax_number": "435-755-6091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "517 W 100 N Ste 110",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "UT",
            "postal_code": "843329826",
            "country_code": "US",
            "telephone_number": "435-755-6075",
            "fax_number": "435-374-0502",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 S Main St",
            "address_purpose": "LOCATION",
            "city": "Randolph",
            "state": "UT",
            "postal_code": "840647701",
            "country_code": "US",
            "telephone_number": "435-755-6061",
            "fax_number": "435-994-3806",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 W 200 N",
            "address_purpose": "LOCATION",
            "city": "Brigham City",
            "state": "UT",
            "postal_code": "843022109",
            "country_code": "US",
            "telephone_number": "435-723-7999",
            "fax_number": "435-723-7331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 W Logan Rd",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "UT",
            "postal_code": "840287754",
            "country_code": "US",
            "telephone_number": "435-946-3660",
            "fax_number": "435-946-8215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDRINGTON",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-26",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "10834612-3501",
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "10834612-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Day
• Jackson Walter Deere, MD
• Discover Wellness Center, LLC
• Susan A Doucette, PT
• Melanie Douglass, RD
• Leila Elmi-Stuart, LCSW
• Kade Erickson, DPT
• Christopher Fabricius, ND
• Deborah Ruth Flansburg, CNM, MS
• Jaylie Folkman

• Clinical Social Worker in North Logan, UT
• Providers in North Logan, 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 Nov 22, 2022; 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.