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Barbara Ann Scoville

Social Worker

Behavioral Health & Social Service Providers

5635 South Waterbury Way, Suite C-202, Salt Lake City, UT 84121

PECOS Enrollment

This provider is enrolled in PECOS as BARBARA SCOVILLE.

Based on the most recent information from CMS, provider Barbara Ann Scoville is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1538149141
Provider Type
Individual
Full Name
Scoville, Barbara Ann
Title
Mrs.
Credential
LCSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
1/19/2006
Last Updated
7/8/2007

Contact Information

Practice Location

5635 South Waterbury Way, Suite C-202, Salt Lake City, UT 84121

(801) 278-0200

(801) 273-0320

Mailing Location

9729 Sweet Blossom Dr, South Jordan, UT 84095-3217

(801) 253-3606

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 4927001-3501 Utah

Provider Identifiers

ID	Description	Issuer
ID 107018310101	Description Other	Issuer INTERMOUNTAIN HEALTHCARE Utah
ID QO7203	Description Other	Issuer ICAR Utah
ID 49270013501	Description Medicaid	Issuer Unlisted Utah
ID 802653	Description Other	Issuer DESERET MUTUAL Utah
ID 942938348BS1	Description Other	Issuer EDUCATORS MUTUAL Utah
ID 942938348003	Description Other	Issuer CHAMPUS Utah

Barbara Ann Scoville

PECOS Enrollment

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