William J Selfridge Jr., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

356125-3501 Issued in UT

Practice address

2480 S Main St
# 205
Salt Lake City, UT 84115-3058

Phone

(801) 706-1467

Fax

(801) 435-3750

NPI assigned

Oct 2, 2012

Last updated

Apr 13, 2016By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Angels Crossing Hospice and Home Health

  • Hospice and Palliative Medicine (Surgery) Physician
  • Pago Pago, AS
  • NPI 1366915100
  NPD (past)

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460505600000",
    "number": "1821349739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 S MAIN ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841153058",
            "telephone_number": "801-706-1467",
            "fax_number": "801-435-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 S MAIN ST",
            "address_2": "# 205",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841153058",
            "telephone_number": "801-706-1467",
            "fax_number": "801-435-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELFRIDGE",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-02",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "356125-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mehtab Kaur Sekhon, MD
• Selina Sekulic, D.P.M
• Andy Sekutowski
• Selarom Surgical Center, LLC
• William John Self, FNP-C
• Sheryl Anne Seliger, LCSW
• Steven G. Seliger, LMFT
• Motaz Selim, M.D.
• Floralie Beliard Selin, ADULT CARE WORKER
• Emma Selis, BCBA

• 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 13, 2016; 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.