Active NPI
Nicole Demke
- Clinical Psychologist
- SLC, UT
National Provider Identifier
1740894336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 103TC0700X
- Practice address
- 515 S 700 E Ste 2a
SLC, UT 84102-2855 - Phone
- (800) 434-8923
- NPI assigned
- Sep 2, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 103TC0700X | UT | Primary |
Addresses
Primary practice location
515 S 700 E Ste 2a
SLC, UT 84102-2855
Mailing address
515 S 700 E # Suited2A
SLC, UT 84102-2801
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
| License | State | Type | Specialty |
|---|---|---|---|
| 103TC0700X | UT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599004800000",
"number": "1740894336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 S 700 E # SUITED2A",
"city": "SLC",
"state": "UT",
"postal_code": "841022801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 S 700 E STE 2A",
"city": "SLC",
"state": "UT",
"postal_code": "841022855",
"telephone_number": "800-434-8923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMKE",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-02",
"last_updated": "2020-09-02",
"certification_date": "2020-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "103TC0700X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in SLC, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.