Active NPI
Susan Helma Gorey, LCSW, JD
- Clinical Social Worker
- Salt Lake City, UT
National Provider Identifier
1679838965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7074925-3501
- Practice address
- 461 East 500 South
Suite 100
Salt Lake City, UT 84111-2138 - Phone
- (801) 891-4751
- Fax
- (866) 882-2957
- NPI assigned
- Jul 12, 2012
- Last updated
- Jul 12, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 7074925-3501 | UT | Primary |
Addresses
Primary practice location
461 East 500 South
Suite 100
Salt Lake City, UT 84111-2138
Mailing address
461 East 500 South
Suite 100
Salt Lake City, UT 84111-2138
Phone (801) 891-4751
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 17, 2020 through Jun 17, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Juris Doctor
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7074925-3501 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342051200000",
"number": "1679838965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "461 EAST 500 SOUTH",
"address_2": "SUITE 100",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841112138",
"telephone_number": "801-891-4751",
"fax_number": "866-882-2957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "461 EAST 500 SOUTH",
"address_2": "SUITE 100",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841112138",
"telephone_number": "801-891-4751",
"fax_number": "866-882-2957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOREY",
"first_name": "SUSAN",
"middle_name": "HELMA",
"name_prefix": "Ms.",
"credential": "LCSW, JD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-12",
"last_updated": "2012-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "7074925-3501",
"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 Jul 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.