MATTHEW DENHALTER LCSW
NPI 1154597193
Social Worker - Clinical in St George, UT

NPI Status: Active since April 30, 2008

Contact Information

474 W 200 N
SUITE 300
ST GEORGE, UT
ZIP 84770
Phone: (435) 634-5600
Fax: (435) 986-8700

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  • Individual
  • Male
  • Years of Experience 33
  • Social Worker
  • Clinical
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MATTHEW DENHALTER

This page provides the complete NPI Profile along with additional information for Matthew Denhalter, a provider established in St George, Utah with a medical specialization in Social Worker, focusing in clinical and more than 33 years of experience. The healthcare provider is registered in the NPI registry with number 1154597193 assigned on April 2008. The practitioner's primary taxonomy code is 1041C0700X with license number 314692-3501 (UT). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI
1154597193
Provider Name
MATTHEW DENHALTER LCSW
Gender
Male
Entity Type
Individual
Location Address
474 W 200 N SUITE 300 ST GEORGE, UT 84770
Location Phone
(435) 634-5600
Location Fax
(435) 986-8700
Mailing Address
474 W 200 N SUITE 300 ST GEORGE, UT 84770
Mailing Phone
(435) 634-5600
Mailing Fax
(435) 986-8700
Medical School Name
OTHER
Graduation Year
1993
Is Sole Proprietor?
No
Enumeration Date
04-30-2008
Last Update Date
08-04-2021
Code Navigator

A clinical social worker like Matthew Denhalter is licensed to diagnose and treat mental, behavioral, and emotional disorders. A clinical social worker helps patients develop strategies to change behavior or cope with difficult situations and refer patients to other resources or services, such as support groups or other mental health professionals.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Social Worker Clinical

Taxonomy Code
1041C0700X
Type
Behavioral Health & Social Service Providers
License No.
314692-3501
License State
UT
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BridgeSpan Standard Bronze Plan - HMO
  • BridgeSpan Standard Gold Plan - HMO
  • BridgeSpan Standard Silver Plan - HMO
  • Connect 1500 Gold - EPO
  • Connect 6000 Silver - EPO
  • Connect 9800 Bronze - EPO
  • HSA Qualified 7500 Bronze - Choice Network - EPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO
  • Providence Oregon Standard Silver Plan - Signature Network - EPO
  • Bronze 8000 - EPO
  • Bronze Essential 9000 Deductible With 4 Copay No Deductible Office Visits - EPO
  • Bronze HSA 7000 - EPO
  • Gold 2300 - EPO
  • Regence Standard Bronze 7500 - EPO
  • Regence Standard Gold 2000 - EPO
  • Regence Standard Silver 6000 - EPO
  • Silver 6500 - EPO
  • Med Benchmark Expanded Bronze Select Copay Plan - HMO
  • Med Benchmark Expanded Bronze Standardized Plan - HMO
  • Med Benchmark Gold Standardized Plan - HMO
  • Med Benchmark Platinum - HMO
  • Med Benchmark Platinum Standardized Plan - HMO
  • Med Benchmark Silver 6000 Medical Deductible w/Vision - HMO
  • Med Benchmark Silver Standardized Plan - HMO
  • Med Gold 1500 Medical Deductible - HMO
  • Value Benchmark Expanded Bronze Select Copay Plan - HMO
  • Value Benchmark Gold Standardized Plan - HMO
  • Value Benchmark Platinum - HMO
  • Value Benchmark Platinum Standardized Plan - HMO
  • Value Benchmark Silver 5900 Medical Deductible - HMO
  • Value Benchmark Silver Standardized Plan - HMO
  • Value Expanded Bronze 6900 Medical Deductible - HMO
  • Value Gold 1500 Medical Deductible - HMO
  • Value Silver 3000 Medical Deductible - HMO
  • Healthy Premier Bronze HSA - EPO
  • Healthy Premier Expanded Bronze Standard - EPO
  • Healthy Premier Gold Copay Office Visits - EPO
  • Healthy Premier Gold Standard - EPO
  • Healthy Premier Silver Copay Office Visits - EPO
  • Healthy Premier Silver Standard - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Matthew Denhalter is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Matthew Denhalter is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 244460756

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20140303000561

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: No

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Psychotherapy, 1 hour

Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.

This service was performed 107 times for 21 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $0 for a new patient copayment and $17 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 84770 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is NA

  • Average New Patient Price $0
  • Minimum New Patient Price $54.34
  • Maximum New Patient Price $166.03
  • Average New Patient Copayment $0
  • Minimum New Patient Copayment $13.58
  • Maximum New Patient Copayment $41.5

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $68.01
  • Minimum Established Patient Price $17.23
  • Maximum Established Patient Price $135.2
  • Average Established Patient Copayment $17
  • Minimum Established Patient Copayment $4.3
  • Maximum Established Patient Copayment $33.8

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Reviews for MATTHEW DENHALTER LCSW

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1154597193, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
4
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
9
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
1
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 5 → 10 → 1 7 → 14 → 5 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 0 + 4 + 1 + 0 + 9 + 1 + 4 + 1 + 1 + 8 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1154597193.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Clinic/Center (Rehabilitation, Substance Use Disorder)
474 W 200 N, #300
ST GEORGE, UT 84770
Clinic/Center (Mental Health (Including Community Mental Health Center))
474 W 200 N
ST GEORGE, UT 84770
Clinic/Center (Multi-Specialty)
474 W 200 N, #300
ST GEORGE, UT 84770
Social Worker (Clinical)
474 W 200 N
ST GEORGE, UT 84770
Nurse Practitioner (Psychiatric/Mental Health)
474 W 200 N
ST GEORGE, UT 84770
Social Worker (Clinical)
474 W 200 N, SUITE 200
ST GEORGE, UT 84770
Social Worker (Clinical)
474 W 200 N, SUITE 100
ST GEORGE, UT 84770
Marriage & Family Therapist
474 W 200 N, SUITE 100
ST GEORGE, UT 84770
Social Worker (Clinical)
474 W 200 N, SUITE 300
ST GEORGE, UT 84770
Social Worker (Clinical)
474 W 200 N, SUITE 100
ST GEORGE, UT 84770
Social Worker (Clinical)
474 W 200 N, SUITE 100
ST GEORGE, UT 84770
Social Worker (Clinical)
474 W 200 N, SUITE 200
ST GEORGE, UT 84770
Social Worker (Clinical)
474 W 200 N, SUITE 100
ST GEORGE, UT 84770
Counselor (Addiction (Substance Use Disorder))
474 W 200 N, SUITE 200
ST GEORGE, UT 84770
Psychologist (Clinical)
474 W 200 N, SUITE 100
ST GEORGE, UT 84770
Case Manager/Care Coordinator
474 W 200 N, SUITE 100
ST GEORGE, UT 84770
Psychologist (Clinical)
474 W 200 N, SUITE 100
ST GEORGE, UT 84770
Technician, Other
474 W 200 N, SUITE 100
ST GEORGE, UT 84770
Technician, Other
474 W 200 N, SUITE 100
ST GEORGE, UT 84770
Psychologist (Clinical)
474 W 200 N, SUITE 200
ST GEORGE, UT 84770

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1154597193, enumerated as an "individual" on April 30, 2008.

The provider is located at 474 W 200 N SUITE 300 ST GEORGE, UT 84770 and the phone number is (435) 634-5600.

Social Worker with taxonomy code 1041C0700X and a focus in Clinical.

The provider might be accepting Accepts: BridgeSpan Health Company, Providence Health Plan,. Please consult your insurance carrier or call the provider to verify.