Individual provider Active NPI

Casey Paul Fife

  • Social Worker
  • Brigham City, UT
National Provider Identifier
1720492887
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
10590005-3502 Issued in UT
Practice address
862 S Main
Suite 4
Brigham City, UT 84302
Phone
(435) 754-4735
NPI assigned
Jun 17, 2014
Reactivated
Jul 3, 2018
Last updated
Oct 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Social Worker 104100000X 10590005-3502 UT Primary

Addresses

Primary practice location

862 S Main
Suite 4
Brigham City, UT 84302

Mailing address

9045 S 1300 E Ste 200
Sandy, UT 84094-3134
Phone (801) 666-6834

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
I20230424000542 UT Practitioner - Clinical Social Worker 2860857091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compass Counseling and ConsultingGroup PAC ID 0042525990, 6 clinicians

Practice addresses (Care Compare)

4000 S 700
Suite 9
Salt Lake City, UT 84107-2581
Phone (801) 639-3544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10590005-3502UTMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Live for Life Behavioral Health, LLC Single Specialty CurrentSince Oct 25, 2020 Accepting new patients
Compass Counseling and Consulting Single Specialty CurrentSince Jan 1, 2023 Accepting new patients
Live for Life LLC PastSince Oct 25, 2020 Accepting new patients

Locations

3970 S 700 E
Ste 17
Salt Lake City, UT 84107
Phone (801) 639-3544

4000 S 7th E
Ste 9
Salt Lake Cty, UT 84107
Phone (801) 635-4141

9045 S 1300 E
#200
Sandy, UT 84094
Phone (801) 666-6834

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1720492887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9045 S 1300 E STE 200",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840943134",
            "telephone_number": "801-666-6834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "862 S MAIN",
            "address_2": "SUITE 4",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "84302",
            "telephone_number": "435-754-4735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIFE",
        "first_name": "CASEY",
        "middle_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-17",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "deactivation_date": "2018-06-01",
        "reactivation_date": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "10590005-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brigham City, UT

Sources for this page

Verify at the official NPI Registry.