Active NPI
Jessica Holzbauer, LCSW
- Clinical Social Worker
- Salt Lake City, UT
National Provider Identifier
1851663843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7576154-3501
- Practice address
- 925 E 900 S
#42
Salt Lake City, UT 84105-1401 - Phone
- (801) 657-0897
- NPI assigned
- Feb 6, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 7576154-3501 | UT | Primary |
Addresses
Primary practice location
925 E 900 S
#42
Salt Lake City, UT 84105-1401
Mailing address
925 E 900 S
#42
Salt Lake City, UT 84105-1401
Phone (801) 657-0897
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jholzbauer127599@direct.med.utah.edu | Direct | UNIVERSITY OF UTAH |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creative Life Counseling | Clinical | Past | Accepting new patients |
Interoperability endpoints
- jholzbauer127599@direct.med.utah.edu
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.
-
- Clinical Social Worker
- Salt Lake City, UT
- NPI 1699051219
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638403200000",
"number": "1851663843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 E 900 S",
"address_2": "#42",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841051401",
"telephone_number": "801-657-0897"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 E 900 S",
"address_2": "#42",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841051401",
"telephone_number": "801-657-0897"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLZBAUER",
"first_name": "JESSICA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-06",
"last_updated": "2021-12-02",
"certification_date": "2021-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "7576154-3501",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jholzbauer127599@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "UNIVERSITY OF UTAH",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.