Timothy Shea Enniss, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5664530-3501 Issued in UT

Practice address

1208 E 3300 S
Salt Lake City, UT 84106-2522

Phone

(801) 483-1600

Fax

(801) 483-1610

NPI assigned

Sep 15, 2006

Sex

Male

Sole proprietor

No

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

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

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Comprehensive Psychological Services IncGroup PAC ID 2365345741, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Comprehensive Psychological Services Inc

  • Psychologist
  • Salt Lake City, UT
  • NPI 1407878333
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1750487864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2922 W 12875 S",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840656846",
            "telephone_number": "801-979-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 E 3300 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062522",
            "telephone_number": "801-483-1600",
            "fax_number": "801-483-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNISS",
        "first_name": "TIMOTHY",
        "middle_name": "SHEA",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "5664530-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Enhanced Living Counseling, LLC
• Jennifer Enix
• Mindalyn Green Enlow, S.L.P.
• Taylor Enman
• John Kevin Enniss, LCSW
• Toby Merrill Enniss, M.D.
• Angela Enno, PH.D.
• Anneke Elizabeth Enquist
• Brennan J. Enright, MD
• Ensign Peak Services Inc.

• Clinical Social Worker in Salt Lake City, UT
• Providers in Salt Lake City, 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, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.