Individual provider Active NPI

Brad Christensen

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1124370440
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9169380-3501 Issued in UT
Practice address
660 S 200 E Ste 250
Salt Lake City, UT 84111-3846
Phone
(801) 359-2256
NPI assigned
Oct 10, 2012
Last updated
Apr 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 9169380-3501 UT Primary

Addresses

Primary practice location

660 S 200 E Ste 250
Salt Lake City, UT 84111-3846

Mailing address

351 S Goshen St
Salt Lake Cty, UT 84104-1217
Phone (801) 643-0004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200901000701 TX Practitioner - Clinical Social Worker 0547687881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

660 S 200
Suite 250
Salt Lake City, UT 84111-3846

660 S 200 E
Salt Lake, UT 84111-3846
Phone (801) 395-2256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9169380-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Confederated Tribes of the Goshute Reservation CurrentSince May 27, 2020 Accepting new patients
Confederated Tribes of the Goshute Reservation CurrentSince May 27, 2020 Accepting new patients
Confederated Tribes of the Goshute Reservation Past Accepting new patients

Locations

195 Tribal Center Rd
Ibapah, UT 84034
Phone (435) 234-1302

660 S 200 E
Ste 250
Slc, UT 84111
Phone (801) 395-2256

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1124370440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 S GOSHEN ST",
            "city": "SALT LAKE CTY",
            "state": "UT",
            "postal_code": "841041217",
            "telephone_number": "801-643-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S 200 E STE 250",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841113846",
            "telephone_number": "801-359-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "BRAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-10",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "9169380-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.