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JACOB K VICKREY LCSW
NPI 1053889501
Social Worker - Clinical in South Jordan, UT

Active since November 02, 2018Opted out of Medicare · through Apr 1, 2027
11748 S 3600 W STE 3, SOUTH JORDAN, UT 84095(801) 896-8133 Get Directions Write a Review

NPPES record last updated: August 16, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 16, 2024, Oct 19, 2022, Nov 2, 2018 (3 updates tracked since 2018).

About Jacob K Vickrey Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB K VICKREY LCSW (NPI 1053889501) is an individual clinical provider in South Jordan, Utah, licensed in Utah (9742056-3501) and active in the NPI registry since November 2018. He has opted out of Medicare through April 1, 2027.

NPPES Registry Identity

NPI1053889501
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameJACOB K VICKREYCredential: LCSW
Location Address11748 S 3600 W STE 3South Jordan, UT 84095-5922
Mailing Address14664 S Ward Hills CirHerriman, UT 84096-1256 · (760) 792-3671
Phone(801) 896-8133
Sole ProprietorYes
Enumeration DateNovember 2, 2018
Last NPPES UpdateAugust 16, 20243 updates tracked since enumeration
NPPES CertifiedAugust 16, 2024
✔ NPI 1053889501 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in UT · 9742056-3501
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
11748 S 3600 W STE 3, South Jordan, UT 84095
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Utah, Select Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jacob K Vickrey Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2023 through April 1, 2027.

Opt-Out Effective DateApril 1, 2023
Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LIVE WELL COUNSELING SERVICES PLLC
Social Worker (Clinical)
11748 S 3600 W STE 3
SOUTH JORDAN, UT 84095
Salt Lake County (801) 896-8133

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Vickrey's NPI number?

The NPI number for Jacob Vickrey is 1053889501. It was assigned to this individual provider in the NPPES registry on November 2, 2018.

Where is Jacob Vickrey located?

Jacob Vickrey practices at 11748 S 3600 W Ste 3, South Jordan, UT 84095. The listed phone number is (801) 896-8133.

What is Jacob Vickrey's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Jacob Vickrey enrolled in Medicare?

No. Jacob Vickrey has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Jacob Vickrey accept?

Health plans from BridgeSpan Health Company, Regence BlueCross BlueShield of Utah and Select Health list Jacob Vickrey as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacob Vickrey was last updated on August 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.