Individual provider Active NPI

Lydia Midgley, LCSW

  • Clinical Social Worker
  • South Jordan, UT
National Provider Identifier
1730382847
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6623582-3501 Issued in UT
Practice address
1108 W South Jordan Pkwy Ste B
South Jordan, UT 84095-5505
Phone
(801) 755-5531
Fax
(801) 409-7908
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6623582-3502 UT
Clinical Social Worker 1041C0700X 6623582-3501 UT Primary

Addresses

Primary practice location

1108 W South Jordan Pkwy Ste B
South Jordan, UT 84095-5505

Mailing address

1108 W South Jordan Parkway
Ste B
South Jordan, UT 84095-1215
Phone (801) 755-5531

Other practice location 1

1141 E 3900 S
Ste A160
Salt Lake City, UT 84124-1215
Phone (801) 284-4490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6623582-3502UTMDSocial Worker
6623582-3501UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730382847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 W SOUTH JORDAN PARKWAY",
            "address_2": "STE B",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840951215",
            "telephone_number": "801-755-5531",
            "fax_number": "801-409-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 W SOUTH JORDAN PKWY STE B",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955505",
            "telephone_number": "801-755-5531",
            "fax_number": "801-409-7908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1141 E 3900 S",
            "address_2": "Ste A160",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841241215",
            "country_code": "US",
            "telephone_number": "801-284-4490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIDGLEY",
        "first_name": "LYDIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "6623582-3502",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "6623582-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.