Ejay Jack, LCSW
NPI 1306500590 · Clinical Social Worker · Salt Lake City, UT
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ejay Jack, LCSW is a Clinical Social Worker provider in Salt Lake City, UT (NPI 1306500590).
Provider details
- NPI number
- 1306500590
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- No
- License
- 24475 (MN)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2021-10-25
- Last updated
- 2021-10-25
- Certified
- 2021-10-25
Frequently asked questions
- What is Ejay Jack's NPI number?
- Ejay Jack's National Provider Identifier (NPI) is 1306500590, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ejay Jack's specialty?
- Ejay Jack is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Ejay Jack located?
- Ejay Jack's practice location on file with NPPES is 389 S 900 E, Salt Lake City, UT 84102-2310.
- What is Ejay Jack's phone number?
- The practice phone number listed in the NPPES registry for Ejay Jack is (385) 282-2500.
- Does Ejay Jack accept Medicare?
- Ejay Jack is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Ejay Jack's NPI active?
- Yes — Ejay Jack's NPI (1306500590) is active in the NPPES registry as of the last update on 2021-10-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.