Active NPI
Jeremy Cottle, PH.D., L.C.S.W.
- Clinical Social Worker
- Orem, UT
National Provider Identifier
1831520535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7765390-3501
- Practice address
- 1350 E 750 N
Orem, UT 84097-4345 - Phone
- (801) 836-4605
- NPI assigned
- Dec 5, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 | 7765390-3501 | UT | Primary |
| Clinical Social Worker | 1041C0700X | 32527 | TX |
Addresses
Primary practice location
1350 E 750 N
Orem, UT 84097-4345
Mailing address
1768 S 1440 E
Spanish Fork, UT 84660-3523
Phone (801) 836-4605
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32527 | TX | MD | Clinical Social Worker |
| 7765390-3501 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386201600000",
"number": "1831520535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1768 S 1440 E",
"city": "SPANISH FORK",
"state": "UT",
"postal_code": "846603523",
"telephone_number": "801-836-4605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 E 750 N",
"city": "OREM",
"state": "UT",
"postal_code": "840974345",
"telephone_number": "801-836-4605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COTTLE",
"first_name": "JEREMY",
"name_prefix": "Dr.",
"credential": "PH.D., L.C.S.W.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-12-05",
"last_updated": "2013-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "7765390-3501",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "32527",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Dec 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.