Theresa Mathis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6722056-3501 Issued in UT

Practice address

189 S State St Ste 230
Clearfield, UT 84015-1001

Phone

(801) 781-0959

NPI assigned

Jan 11, 2013

Last updated

Jun 26, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Came2Believe, LLC

  • Clinical Social Worker
  • Clearfield, UT
  • NPI 1205488772
  Medicare reassignment NPD Authorized official
• Quality Youth Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Harrisville, UT
  • NPI 1023335890
  NPD (past)

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1902143803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 N MAIN ST",
            "city": "WILLARD",
            "state": "UT",
            "postal_code": "843409738",
            "telephone_number": "801-781-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 S STATE ST STE 230",
            "city": "CLEARFIELD",
            "state": "UT",
            "postal_code": "840151001",
            "telephone_number": "801-781-0959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1140 36th St Ste 270",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "844032064",
            "country_code": "US",
            "telephone_number": "801-389-6695",
            "fax_number": "801-393-4086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "THERESA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-11",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "6722056-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald E. Manwill, PH.D.
• Brandon Scott Martindale, PT
• Paisley Martinez
• Wendi Midori Martinez
• Everett Mathis
• Rondi Mattson, PH.D.
• Kennedy Matua
• Brandon May
• Mayer Chiropractic and Wellness PC
• Mayer Chiropractic Inc

• Clinical Social Worker in Clearfield, UT
• Providers in Clearfield, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.