MIMI GORDON-LEVINE LCSW
NPI 1063485399
Social Worker - Clinical in Salt Lake City, UT

Q: What is Mimi Gordon-levine's NPI number?

The NPI number for Mimi Gordon-levine is 1063485399. It was assigned to this individual provider in the NPPES registry on February 8, 2006.

Q: What is Mimi Gordon-levine's specialty?

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

Q: Is Mimi Gordon-levine enrolled in Medicare?

No. Mimi Gordon-levine has opted out of Medicare through July 11, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Active since February 08, 2006Opted out of Medicare · through Jul 11, 2028

1141 E 3900 S, STE A160, SALT LAKE CITY, UT 84124(801) 264-2325 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

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About Mimi Gordon-levine Lcsw NPPES

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

MIMI GORDON-LEVINE LCSW (NPI 1063485399) is an individual clinical provider in Salt Lake City, Utah, licensed in Utah (941409633501) and active in the NPI registry since February 2006. She has opted out of Medicare through July 11, 2028.

NPPES Registry Identity

NPI1063485399

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMIMI GORDON-LEVINECredential: LCSW

Location Address1141 E 3900 S, STE A160Salt Lake City, UT 84124-1215

Mailing Address1141 E 3900 S, Ste A160Salt Lake City, UT 84124-1215 · (801) 264-2325

Phone(801) 264-2325

Sole ProprietorNo

Enumeration DateFebruary 8, 2006

Last NPPES UpdateJuly 13, 2026

✔ NPI 1063485399 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 · 941409633501

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.

1141 E 3900 S, Salt Lake City, UT 84124

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mimi Gordon-levine 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 July 11, 2024 through July 11, 2028.

Opt-Out Effective DateJuly 11, 2024

Opt-Out In Effect ThroughJuly 11, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

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

MR. JARED ANDES CSW

Social Worker (Clinical)

1141 E 3900 S, STE A170
SALT LAKE CITY, UT 84124

Salt Lake County (801) 293-7400

KAREN LEE PLATIS LCSW

Social Worker (Clinical)

1141 E 3900 S, SUITE A-170
SALT LAKE CITY, UT 84124

Salt Lake County (801) 270-6507

MS. SUZANN SUTTON NOWELS LCSW

Social Worker (Clinical)

1141 E 3900 S, A-160
SALT LAKE CITY, UT 84124

Salt Lake County (801) 264-2325

MRS. SANDRA KAY VARLEY LCSW

Social Worker (Clinical)

1141 E 3900 S, SUITE A-170
SALT LAKE CITY, UT 84124

Salt Lake County (801) 284-4990

MISS RACHEL J. ARMSTRONG CSW

Social Worker (Clinical)

1141 E 3900 S
SALT LAKE CITY, UT 84124

Salt Lake County (801) 284-4990

VALLEY MENTAL HEALTH INCORPORATED

Psychiatry & Neurology (Psychiatry)

1141 E 3900 S, SUITE A170
SALT LAKE CITY, UT 84124

Salt Lake County (801) 284-4990

SYDNEY DAHMEN

Specialist/Technologist, Health Information

1141 E 3900 S
SALT LAKE CITY, UT 84124

Salt Lake County (801) 263-7142

MS. DIANE H. JONES LCSW

Social Worker (Clinical)

1141 E 3900 S, STEA160
SALT LAKE CITY, UT 84124

Salt Lake County (801) 264-2325

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 Mimi Gordon-levine's NPI number?

The NPI number for Mimi Gordon-levine is 1063485399. It was assigned to this individual provider in the NPPES registry on February 8, 2006.

Where is Mimi Gordon-levine located?

Mimi Gordon-levine practices at 1141 E 3900 S Ste A160, Salt Lake City, UT 84124. The listed phone number is (801) 264-2325.

What is Mimi Gordon-levine's specialty?

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

Is Mimi Gordon-levine enrolled in Medicare?

No. Mimi Gordon-levine has opted out of Medicare through July 11, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Mimi Gordon-levine was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.