Active NPI
Jeni Scarlett Koyle, CSW
- Clinical Social Worker
- North Salt Lake, UT
National Provider Identifier
1679176028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11841804-3502
- Practice address
- 292 Odell LN Apt 4
North Salt Lake, UT 84054-4107 - Phone
- (801) 218-2951
- NPI assigned
- Nov 18, 2020
- Last updated
- Nov 18, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 11841804-3502 | UT | Primary |
Addresses
Primary practice location
292 Odell LN Apt 4
North Salt Lake, UT 84054-4107
Mailing address
1578 W 1700 S Ste 200
Salt Lake City, UT 84104-3461
Phone (801) 972-2711
Other practice location 1
1578 W 1700 S Ste 200
Salt Lake City, UT 84104-3461
Phone (801) 972-2711
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11841804-3502 | UT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Child & Family Empowerment Services, LLC | Clinical | Past | Accepting new patients |
| Child and Family Empowerment Services, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Social Worker
- Salt Lake City, UT
- NPI 1568424828
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Salt Lake City, UT
- NPI 1649684903
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605657600000",
"number": "1679176028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1578 W 1700 S STE 200",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841043461",
"telephone_number": "801-972-2711",
"fax_number": "801-972-2709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "292 ODELL LN APT 4",
"city": "NORTH SALT LAKE",
"state": "UT",
"postal_code": "840544107",
"telephone_number": "801-218-2951"
}
],
"practiceLocations": [
{
"address_1": "1578 W 1700 S Ste 200",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841043461",
"country_code": "US",
"telephone_number": "801-972-2711",
"fax_number": "801-972-2709",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOYLE",
"first_name": "JENI",
"middle_name": "SCARLETT",
"credential": "CSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-18",
"last_updated": "2020-11-18",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "11841804-3502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Salt Lake, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.