Individual provider Active NPI

Sherlene Clark Dean, APRN

  • Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
  • SLC, UT
National Provider Identifier
1871603860
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0807X
License
204333-4405 Issued in UT
Practice address
650 S Komas Dr Ste 208
SLC, UT 84108-1241
Phone
(801) 585-1212
Fax
(801) 585-9096
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist 364SP0807X 204333-4405 UT Primary

Addresses

Primary practice location

650 S Komas Dr Ste 208
SLC, UT 84108-1241

Mailing address

PO Box 413076
Salt Lake City, UT 84141-3076
Phone (801) 213-3900

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
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seasons Health Care Group LLC PastSince Nov 16, 2011 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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1871603860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413076",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841413076",
            "telephone_number": "801-213-3900",
            "fax_number": "801-585-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 S KOMAS DR STE 208",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841081241",
            "telephone_number": "801-585-1212",
            "fax_number": "801-585-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "SHERLENE",
        "middle_name": "CLARK",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "UT",
            "license": "204333-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in SLC, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.