Individual provider Active NPI

Stephanie L Gardner, LCSW

  • Clinical Social Worker
  • Pleasant Grove, UT
National Provider Identifier
1720488919
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10208381-3501 Issued in UT
Practice address
66 E State Rd
Pleasant Grove, UT 84062-2637
Phone
(801) 876-0036
NPI assigned
Aug 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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 10208381-3501 UT Primary

Addresses

Primary practice location

66 E State Rd
Pleasant Grove, UT 84062-2637

Mailing address

66 E State Rd
Pleasant Grove, UT 84062-2637
Phone (385) 325-1983

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.
Opted out of Medicare
Yes, effective Oct 24, 2023 through Oct 24, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10208381-3501UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1720488919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 E STATE RD",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840622637",
            "telephone_number": "385-325-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 E STATE RD",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840622637",
            "telephone_number": "801-876-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "10208381-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Grove, UT

Sources for this page

Verify at the official NPI Registry.