Individual provider Active NPI

Sandra Deirdre Ehninger, LCSW

  • Clinical Social Worker
  • Midvale, UT
National Provider Identifier
1720009285
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1300793501 Issued in UT
Practice address
1225 Fort Union Blvd Ste 215
Midvale, UT 84047-1882
Phone
(801) 501-4350
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1300793501 UT Primary

Addresses

Primary practice location

1225 Fort Union Blvd Ste 215
Midvale, UT 84047-1882

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 501-4350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040924000401 UT Practitioner - Clinical Social Worker 8325016595 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (435) 743-5555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1300793501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Jan 8, 2013 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jun 1, 2004 Accepting new patients
Ihc Health Services Inc CurrentSince Jun 1, 2004 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1225 E Fort Union Blvd
Ste 215
Midvale, UT 84047
Phone (801) 233-4200

5770 S 250 E
Ste 300
Salt Lake City, UT 84107
Phone (801) 314-2500

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1720009285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-501-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 FORT UNION BLVD STE 215",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471882",
            "telephone_number": "801-501-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHNINGER",
        "first_name": "SANDRA",
        "middle_name": "DEIRDRE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "1300793501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

Verify at the official NPI Registry.