Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jaci Faulkner

Individual provider Clinical Social Worker · NPI 1619648615

Jaci Faulkner is a Clinical Social Worker in Clinton, Utah. Qualified in 2023, 3 years ago. Practices with Tanner Memorial Clinic, a 252-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
3
Licensed in
UT
In the registry since
2021

Practice location Address checks out

1477 N 2000 W
Clinton, UT 84015-8638
Phone: (801) 773-4840
Fax: (801) 525-8151
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 13403293-3501 (UT)

Record details

NPI number1619648615
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 21, 2021
Last updated in NPPESApril 14, 2025
Certification dateApril 14, 2025
Mailing addressPo Box 337, Layton, UT 84041-0337

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Tanner Memorial Clinic — 252 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Clinton