James Calvimonte
Individual provider Active NPI Clinical Social Worker · Logan, UT
NPI 1669930277 · NPPES record last updated Mar 4, 2019
Key facts
- NPI
- 1669930277
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 9121936-3502 (UT)
- Practice address
- 150 E 200 N Ste O
Logan, UT 84321-4036 - Phone
- (435) 799-5035
- NPI assigned
- Mar 4, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9121936-3502 | UT | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | 9121936-3502 | UT | Yes |
Addresses
Primary practice location
150 E 200 N Ste O
Logan, UT 84321-4036
Mailing address
554 W Center St
Logan, UT 84321-4428
Phone (435) 764-2479
Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.