Active NPI
Michael Mangan
- Social Worker
- Provo, UT
National Provider Identifier
1821669912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 284431-3502
- Practice address
- 1165 E 300 N
Provo, UT 84606-3539 - Phone
- (801) 373-4760
- Fax
- (801) 373-0639
- NPI assigned
- Jul 8, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 284431-3506 | UT | |
| Social Worker | 104100000X | 284431-3502 | UT | Primary |
Addresses
Primary practice location
1165 E 300 N
Provo, UT 84606-3539
Mailing address
702B S Carterville Rd
Orem, UT 84097-6642
Phone (801) 735-1229
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 |
|---|---|---|---|
| 284431-3502 | UT | MD | Social Worker |
| 284431-3506 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685059200000",
"number": "1821669912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702B S CARTERVILLE RD",
"city": "OREM",
"state": "UT",
"postal_code": "840976642",
"telephone_number": "801-735-1229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1165 E 300 N",
"city": "PROVO",
"state": "UT",
"postal_code": "846063539",
"telephone_number": "801-373-4760",
"fax_number": "801-373-0639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGAN",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-08",
"last_updated": "2023-05-26",
"certification_date": "2023-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "284431-3506",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "UT",
"license": "284431-3502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.