Individual provider Active NPI

Stephanie Jeannette Micheli, CSW

  • School Social Worker
  • Logan, UT
National Provider Identifier
1962914408
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
Practice address
90 E 200 N
Logan, UT 84321-4034
Phone
(435) 752-0750
NPI assigned
Oct 24, 2017
Last updated
Jun 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X NU Primary

Addresses

Primary practice location

90 E 200 N
Logan, UT 84321-4034

Mailing address

90 E 200 N
Logan, UT 84321-4034

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201208001802 UT Practitioner - Clinical Social Worker 5193137677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bear River Mental Health Services IncGroup PAC ID 0840102356, 31 clinicians

Practice addresses (Care Compare)

90 E 200
Logan, UT 84321-4034
Phone (435) 752-0750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bear River Mental Health Services Inc CurrentSince Sep 1, 2020 Accepting new patients

Locations

663 W Hospital Rd
Brigham City, UT 84302
Phone (435) 734-9449

90 E 200 N
Logan, UT 84321
Phone (435) 752-0750

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1962914408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 E 200 N",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843214034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 E 200 N",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843214034",
            "telephone_number": "435-752-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELI",
        "first_name": "STEPHANIE",
        "middle_name": "JEANNETTE",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-24",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

Verify at the official NPI Registry.