Individual provider Active NPI

Christoffer Layton Loderup

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1699386441
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14044069-3501 Issued in UT
Practice address
2319 Foothill Dr, Suite #240
Salt Lake City, UT 84109
Phone
(801) 203-0082
NPI assigned
Aug 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 14044069-3501 UT Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

2319 Foothill Dr, Suite #240
Salt Lake City, UT 84109

Mailing address

2319 Foothill Dr, Suite #240
Salt Lake City, UT 84109
Phone (801) 203-0082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14044069-3501UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1699386441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2319 FOOTHILL DR, SUITE #240",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84109",
            "telephone_number": "801-203-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2319 FOOTHILL DR, SUITE #240",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84109",
            "telephone_number": "801-203-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LODERUP",
        "first_name": "CHRISTOFFER",
        "middle_name": "LAYTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-14",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "14044069-3501",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.