Active NPI
Cassandra Fairclough, MSW, CSW
- Social Worker
- West Jordan, UT
National Provider Identifier
1902065030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6289854-3502
- Practice address
- 9263 Redwood Rd
West Jordan, UT 84088-6571 - Phone
- (801) 566-0749
- NPI assigned
- Jun 4, 2008
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6289854-3502 | UT | Primary |
Addresses
Primary practice location
9263 Redwood Rd
West Jordan, UT 84088-6571
Mailing address
9263 Redwood Rd
West Jordan, UT 84088-6571
Phone (801) 566-0749
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 |
|---|---|---|---|
| 6289854-3502 | UT | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212537600000",
"number": "1902065030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9263 REDWOOD RD",
"city": "WEST JORDAN",
"state": "UT",
"postal_code": "840886571",
"telephone_number": "801-566-0749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9263 REDWOOD RD",
"city": "WEST JORDAN",
"state": "UT",
"postal_code": "840886571",
"telephone_number": "801-566-0749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRCLOUGH",
"first_name": "CASSANDRA",
"credential": "MSW, CSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-04",
"last_updated": "2008-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "UT",
"license": "6289854-3502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.