Active NPI
Joshua Bravo, LCSW
- Mental Health Counselor
- Salt Lake City, UT
National Provider Identifier
1043635097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 7113178-3501
- Practice address
- 1380 S Main St
Salt Lake City, UT 84115-5336 - Phone
- (801) 573-6323
- NPI assigned
- Feb 27, 2014
- Last updated
- May 24, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 7113178-3501 | UT | Primary |
Addresses
Primary practice location
1380 S Main St
Salt Lake City, UT 84115-5336
Mailing address
PO Box 1078
Salt Lake City, UT 84110-1078
Phone (801) 573-6323
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7113178-3501 | UT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558656000000",
"number": "1043635097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1078",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841101078",
"telephone_number": "801-573-6323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1380 S MAIN ST",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841155336",
"telephone_number": "801-573-6323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAVO",
"first_name": "JOSHUA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-02-27",
"last_updated": "2019-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "UT",
"license": "7113178-3501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.