Individual provider Active NPI

Kimberly A Crossley, LCSW

  • Clinical Social Worker
  • Orem, UT
National Provider Identifier
1811061823
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
310948-3501 Issued in UT
Practice address
1790 N State Street
Orem, UT 84057-2025
Phone
(801) 224-8255
Fax
(801) 224-8301
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 310948-3501 UT
Clinical Social Worker 1041C0700X 310948-3501 UT Primary

Addresses

Primary practice location

1790 N State Street
Orem, UT 84057-2025

Mailing address

1790 N State Street
Orem, UT 84057-2025
Phone (801) 224-8255

Other names 1

  • Kimberly C Miller Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
310948-3501UTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wasatch Behavioral Health Special Service District Mental Health PastSince Dec 12, 2010 Accepting new patients
Wasatch Behavioral Health Special Service District Past Accepting new patients

Organizations & group practices 2

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1811061823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 N STATE STREET",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840572025",
            "telephone_number": "801-224-8255",
            "fax_number": "801-224-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 N STATE STREET",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840572025",
            "telephone_number": "801-224-8255",
            "fax_number": "801-224-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSLEY",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "310948-3501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "310948-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MILLER",
            "middle_name": "C",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orem, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.