Individual provider Active NPI

Rebecca Mikva Cohen, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1861886087
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10333326-3501 Issued in UT
Practice address
155 E 900 S Ste 11
Salt Lake City, UT 84111-4229
Phone
(773) 616-7389
NPI assigned
Mar 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10333326-3501 UT Primary

Addresses

Primary practice location

155 E 900 S Ste 11
Salt Lake City, UT 84111-4229

Mailing address

155 E 900 S Ste 11
Salt Lake City, UT 84111-4229
Phone (773) 616-7389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 5, 2023 through Dec 5, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10333326-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
RMC Counseling CurrentSince Jan 19, 2020 Accepting new patients

Locations

155 E 900 S
Ste 11
Salt Lake City, UT 84111
Phone (773) 616-7389

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.

NPI Registry JSON

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1861886087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 E 900 S STE 11",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841114229",
            "telephone_number": "773-616-7389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 E 900 S STE 11",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841114229",
            "telephone_number": "773-616-7389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "REBECCA",
        "middle_name": "MIKVA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-25",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "10333326-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.