Patricia S Bennett, LCSW
Individual provider Active NPI Clinical Social Worker · Roosevelt, UT
NPI 1720161912 · NPPES record last updated Feb 8, 2019
Key facts
- NPI
- 1720161912
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 137380-3501 (UT)
- Practice address
- 285 W 800 S
Roosevelt, UT 84066-3707 - Phone
- (435) 725-6300
- Fax
- (435) 725-6325
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Uintah Basin Tri-County Mental Health and Substance Abuse Local Author
Practice addresses (Care Compare)
1140 W 500
Suite 9
Vernal, UT 84078-2912
285 W 800
Roosevelt, UT 84066-3707
Phone (435) 725-6300
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041206000447 | UT | Practitioner - Clinical Social Worker | 3476519042 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 137380-3501 | UT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Uintah Basin Tri-County Mental Health and Substance Abuse Local Author | Current |
Accepting new patients |
Locations
285 W 800 S
Roosevelt, UT 84066
Phone 43572563006340
290 W 800 S
Roosevelt, UT 84066
1140 W 500 S
Ste 9
Vernal, UT 84078
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 137380-3501 | UT | Yes |
Addresses
Primary practice location
285 W 800 S
Roosevelt, UT 84066-3707
Mailing address
PO Box 345
Neola, UT 84053-0345
Phone (435) 725-6300
Other providers in Roosevelt, UT
- Vail Shanae Batty
- Kerry Robert Baum Jr.
- Garrison Douglas Beach
- Jason S Beales
- Trent Bell
- Megan D'on Berlin
- Beverly Berrett
- Samuel Mark Bertoch
- Bessa, Inc
- Susan Denver Betts
All providers in Roosevelt, UT · Clinical Social Worker in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.