Individual provider Active NPI

Mitchel Phil Acton, CSW

  • Clinical Social Worker
  • South Jordan, UT
National Provider Identifier
1750908786
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11663728-3502 Issued in UT
Practice address
1206 W South Jordan Pkwy Ste D
South Jordan, UT 84095-5519
Phone
(801) 302-3801
Fax
(801) 302-7248
NPI assigned
Jun 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11663728-3502 UT Primary

Addresses

Primary practice location

1206 W South Jordan Pkwy Ste D
South Jordan, UT 84095-5519

Mailing address

1206 W South Jordan Pkwy Ste D
South Jordan, UT 84095-5519
Phone (801) 302-3801

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
11663728-3502UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
South Point Counseling Services, LLC Clinical CurrentSince Jun 28, 2020 Accepting new patients

Locations

1206 W South Jordan Pkwy
Ste D
South Jordan, UT 84095
Phone (801) 302-3801

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1750908786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 W SOUTH JORDAN PKWY STE D",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955519",
            "telephone_number": "801-302-3801",
            "fax_number": "801-302-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 W SOUTH JORDAN PKWY STE D",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955519",
            "telephone_number": "801-302-3801",
            "fax_number": "801-302-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACTON",
        "first_name": "MITCHEL",
        "middle_name": "PHIL",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-25",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "11663728-3502",
            "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 Jun 25, 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.

Verify at the official NPI Registry.