Active NPI
Gary Joel Klein, LCSW
- Clinical Social Worker
- Salt Lake City, UT
National Provider Identifier
1861613853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 5258944 3501
- Practice address
- 1399 S 700 E
Suite 11B
Salt Lake City, UT 84105-2149 - Phone
- (801) 864-7640
- NPI assigned
- May 1, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 5258944 3501 | UT | Primary |
Addresses
Primary practice location
1399 S 700 E
Suite 11B
Salt Lake City, UT 84105-2149
Mailing address
1399 S 700 E
Suite 11B
Salt Lake City, UT 84105-2149
Phone (801) 864-7640
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861613853 | Other | UT | LIFESYNCH |
| 1861613853 | Other | UT | TRIWEST |
| 1861613853 | Other | UT | BLUE CROSS 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5258944 3501 | UT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Behavioral Health Incorporated | Clinical | Past | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- West Valley City, UT
- NPI 1932166980
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311292800000",
"number": "1861613853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1399 S 700 E",
"address_2": "SUITE 11B",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841052149",
"telephone_number": "801-864-7640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1399 S 700 E",
"address_2": "SUITE 11B",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841052149",
"telephone_number": "801-864-7640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEIN",
"first_name": "GARY",
"middle_name": "JOEL",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2011-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "5258944 3501",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIFESYNCH",
"identifier": "1861613853",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIWEST",
"identifier": "1861613853",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF UTAH",
"identifier": "1861613853",
"state": "UT"
}
],
"endpoints": [],
"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 Jul 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.