Individual provider Active NPI

Samantha Dickens, CSW

  • Social Worker
  • Salt Lake City, UT
National Provider Identifier
1902339476
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
8490034-3502 Issued in UT
Practice address
5689 S Redwood Rd Unit 27
Salt Lake City, UT 84123-5499
Phone
(801) 735-7491
NPI assigned
Apr 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 8490034-3502 UT Primary

Addresses

Primary practice location

5689 S Redwood Rd Unit 27
Salt Lake City, UT 84123-5499

Mailing address

5689 S Redwood Rd Unit 27
Salt Lake City, UT 84123-5499
Phone (801) 735-7491

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8490034-3502UTMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1902339476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5689 S REDWOOD RD UNIT 27",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841235499",
            "telephone_number": "801-735-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5689 S REDWOOD RD UNIT 27",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841235499",
            "telephone_number": "801-735-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "SAMANTHA",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-11",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "8490034-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 11, 2017; 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.