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

Theresa Ipolito, CSW

Individual provider Clinical Social Worker · NPI 1194499749

Theresa Ipolito, CSW is a Clinical Social Worker in Salt Lake City, Utah. Qualified in 2023, 3 years ago. Practices with Numinus Wellness UT Inc, a 51-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

154 E Myrtle Ave Ste 204
Salt Lake City, UT 84107-4850
Phone: (801) 369-8989
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 13427226-3502 (UT)

Record details

NPI number1194499749
Entity typeIndividual (Type 1)
GenderFemale
Credentials CSW
Sole proprietorNo
NPI enumeratedAugust 6, 2021
Last updated in NPPESFebruary 1, 2024
Certification dateFebruary 1, 2024

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 Numinus Wellness Ut Inc — 51 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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