Cheryl Kelstrom-Smith, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

47306713501 Issued in UT

Practice address

5522 S 3100 W
Roy, UT 84067-9456

Phone

(801) 710-9986

Fax

(385) 393-8624

NPI assigned

Jan 25, 2007

Last updated

Jan 12, 2023By the provider in NPPES

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

Other names 1

• Ms. Cheryl Kelstrom Former name

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cheryl Kelstrom-Smith LCSW, LLC

  • Clinical Social Worker
  • Riverdale, UT
  • NPI 1417235284
  NPD Authorized official

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1740335850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5522 S 3100 W",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679456",
            "telephone_number": "801-710-9986",
            "fax_number": "385-393-8624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5522 S 3100 W",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679456",
            "telephone_number": "801-710-9986",
            "fax_number": "385-393-8624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5522 S. 3100 W",
            "address_purpose": "LOCATION",
            "city": "Roy",
            "state": "UT",
            "postal_code": "840679456",
            "country_code": "US",
            "telephone_number": "801-710-9986",
            "fax_number": "385-393-8624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELSTROM-SMITH",
        "first_name": "CHERYL",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "47306713501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "KELSTROM",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Roy, UT
• Providers in Roy, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.