Marissa J Van Noy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11991316-3502 Issued in UT

Practice address

11620 S State St Ste 1404
Draper, UT 84020-7124

Phone

(801) 508-4150

NPI assigned

Apr 12, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cradled Soul PLLC

  • Clinical Social Worker
  • Stansbury Park, UT
  • NPI 1871465849
  NPD Authorized official

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1720668916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 E ROCKWOOD WAY",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840745573",
            "telephone_number": "435-850-9708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11620 S STATE ST STE 1404",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207124",
            "telephone_number": "801-508-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN NOY",
        "first_name": "MARISSA",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "11991316-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Utnv Draper, LLC
• Robert Graham Vagstad, RPH
• Valeria Valentini
• Nickolas Vamianakis, PHARMD
• Courtney Van Hoven, PT, DPT
• Hanna Vance
• Jason Ryan Vance, D.C.
• Sydney Vance
• Elaine Vandenhazel
• William Gerritt Vander Linden III

• Clinical Social Worker in Draper, UT
• Providers in Draper, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.