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THERESA IPOLITO CSW
NPI 1194499749
Social Worker - Clinical in Salt Lake City, UT

Active since August 06, 2021PECOS EnrolledAccepts Medicare Assignment
154 E MYRTLE AVE STE 204, SALT LAKE CITY, UT 84107(801) 369-8989 Get Directions Write a Review

NPPES record last updated: February 1, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Theresa Ipolito Csw NPPES

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

THERESA IPOLITO CSW (NPI 1194499749) is an individual clinical provider in Salt Lake City, Utah, licensed in Utah (13427226-3502) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1194499749
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameTHERESA IPOLITOCredential: CSW
Location Address154 E MYRTLE AVE STE 204Salt Lake City, UT 84107-4850
Mailing Address344 E 100 S Ste 301Salt Lake City, UT 84111-1727
Phone(801) 369-8989
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateAugust 6, 2021
Last NPPES UpdateFebruary 1, 2024
NPPES CertifiedFebruary 1, 2024
✔ NPI 1194499749 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 · 13427226-3502
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.
154 E MYRTLE AVE STE 204, Salt Lake City, UT 84107
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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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Theresa Ipolito Csw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1951826536
PECOS Enrollment IDI20250416000739
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Theresa Ipolito reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Numinus Wellness Ut Inc
37 mi
Psychiatry
672 W 400 S STE 201
Springville, UT 84663
  • Reassigned Medicare billing, Utah enrollment
  • 63 clinicians in this Medicare group
NPI 1265092282 (801) 369-8989

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.34 – $166.03
Typical copayment $0.00 (range $13.58 – $41.50)
Most-billed visit code NA
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

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

SEVON TAROIAN
Social Worker (Clinical)
154 E MYRTLE AVE STE 204
MURRAY, UT 84107
Salt Lake County (801) 369-8989
LORRIE MICHELLE BELNAP L.C.S.W.
Social Worker (Clinical)
154 E MYRTLE AVE STE 204
MURRAY, UT 84107
Salt Lake County (801) 369-8989
LINDSAY HELM
Physician Assistant
154 E MYRTLE AVE STE 204
MURRAY, UT 84107
Salt Lake County (801) 369-8989
SAMUEL R EVERETT PA-C
Clinical Nurse Specialist (Psychiatric/Mental Health)
154 E MYRTLE AVE STE 204
MURRAY, UT 84107
Salt Lake County (801) 369-8989
KATHRYN EVANS DOWDEN APRN
Nurse Practitioner (Psychiatric/Mental Health)
154 E MYRTLE AVE STE 204
MURRAY, UT 84107
Salt Lake County (801) 369-8989
SCOTT MICHAEL SALOMONE M.D.
Psychiatry & Neurology (Psychiatry)
154 E MYRTLE AVE STE 204
MURRAY, UT 84107
Salt Lake County (520) 874-2857
MARINA DANIELLE FOWLER
Social Worker (Clinical)
154 E MYRTLE AVE STE 204
MURRAY, UT 84107
Salt Lake County (385) 216-5178
LINDSEY PAIGE GAVIN DNP, APRN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
154 E MYRTLE AVE STE 204
MURRAY, UT 84107
Salt Lake County (801) 369-8989

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 Theresa Ipolito's NPI number?

The NPI number for Theresa Ipolito is 1194499749. It was assigned to this individual provider in the NPPES registry on August 6, 2021.

Where is Theresa Ipolito located?

Theresa Ipolito practices at 154 E Myrtle Ave Ste 204, Salt Lake City, UT 84107. The listed phone number is (801) 369-8989.

What is Theresa Ipolito's specialty?

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

Is Theresa Ipolito enrolled in Medicare?

Yes. Theresa Ipolito is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Theresa Ipolito's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Theresa Ipolito reassigns Medicare benefits to Numinus Wellness Ut Inc (Springville, UT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Theresa Ipolito's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Theresa Ipolito accept?

Health plans from BridgeSpan Health Company, Regence BlueCross BlueShield of Utah and Select Health list Theresa Ipolito 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 Theresa Ipolito was last updated on February 1, 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.