Individual provider Active NPI

Elyssa Stubblefield, LCSW

  • Clinical Social Worker
  • Ogden, UT
National Provider Identifier
1982230611
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13621392-3501 Issued in UT
Practice address
2661 Washington Blvd Ste 204
Ogden, UT 84401-8303
Phone
(801) 317-7837
NPI assigned
Mar 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13621392-3501 UT Primary

Addresses

Primary practice location

2661 Washington Blvd Ste 204
Ogden, UT 84401-8303

Mailing address

965 N Liberty Ave
Ogden, UT 84404-6247
Phone (801) 317-7837

Other practice location 1

965 N Liberty Ave
Ogden, UT 84404-6247
Phone (801) 317-7837

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
I20251107003249 UT Practitioner - Clinical Social Worker 8921597766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3590 Harrison Blvd
GL2
Ogden, UT 84403-2060
Phone (801) 317-7837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13621392-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Amaryllis Counseling Clinical CurrentSince Sep 10, 2025 Accepting new patients

Locations

3590 Harrison Blvd
Ste 2
Ogden, UT 84403
Phone (801) 317-7837

3590 Harrison Blvd
Ste GL2
Ogden, UT 84403
Phone (385) 264-9695

2661 Washington Blvd
Ste 204
Ogden, UT 84401
Phone (801) 317-7837

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": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1982230611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 N LIBERTY AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844046247",
            "telephone_number": "801-317-7837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2661 WASHINGTON BLVD STE 204",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844018303",
            "telephone_number": "801-317-7837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "965 N Liberty Ave",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "844046247",
            "country_code": "US",
            "telephone_number": "801-317-7837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUBBLEFIELD",
        "first_name": "ELYSSA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-13",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "13621392-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.