Individual provider Active NPI

Whitney Thurgood Israelsen

  • Clinical Social Worker
  • Logan, UT
National Provider Identifier
1982952610
Registry record updated Dec 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8304623-3501 Issued in UT
Practice address
655 E 1300 N
Logan, UT 84341
Phone
(435) 792-6491
NPI assigned
Aug 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2014

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 8304623-3501 UT Primary

Addresses

Primary practice location

655 E 1300 N
Logan, UT 84341

Mailing address

655 E 1300 N
Logan, UT 84341
Phone (435) 792-6491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1982952610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 E 1300 N",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "84341",
            "telephone_number": "435-792-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 E 1300 N",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "84341",
            "telephone_number": "435-792-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISRAELSEN",
        "first_name": "WHITNEY",
        "middle_name": "THURGOOD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "8304623-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

Verify at the official NPI Registry.