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NPI Code Detail

MEDICARE: MRS. SYDNEY SALOME SHULTZ LCSW

MEDICARE: MRS. SYDNEY SALOME SHULTZ LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker122781773501UT
2104100000XSocial Worker12278177-3502UT

General Provider Information

NPI Number : 1588235972
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SYDNEY SALOME SHULTZ LCSW
Provider Business Mailing Address
First Line : 453 N 200 W
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84103-1208
Country : US
Telephone Number : 661-414-2953
Fax Number :
Provider Business Practice Location Address
First Line : 950 E 3300 S
Second Line :
City : MILLCREEK
State : UT
Zip : 84106-2141
Country : US
Telephone Number : 385-500-4141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2021
Last Update Date : 04/30/2025

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