Individual provider Active NPI

Brian Miller, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1104296961
Registry record updated Oct 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
138584-3501 Issued in UT
Practice address
5770 S 1500 W
Salt Lake City, UT 84123-5216
Phone
(801) 663-7980
NPI assigned
Oct 5, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 138584-3501 UT Primary

Addresses

Primary practice location

5770 S 1500 W
Salt Lake City, UT 84123-5216

Mailing address

1750 E Yale Ave
Salt Lake City, UT 84108-1836
Phone (801) 608-6581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1104296961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 E YALE AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081836",
            "telephone_number": "801-608-6581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 S 1500 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841235216",
            "telephone_number": "801-663-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BRIAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-05",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "138584-3501",
            "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 Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.