Brett Adam Dustin, CSW
Individual provider Active NPI Social Worker · Price, UT
NPI 1124452669 · NPPES record last updated Nov 6, 2014
Key facts
- NPI
- 1124452669
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 9068999-3502 (UT)
- Practice address
- 453 S Carbon Ave
Price, UT 84501-3226 - Phone
- (435) 650-0315
- NPI assigned
- Sep 1, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9068999-3502 | UT | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 9068999-3502 | UT | Yes |
Addresses
Primary practice location
453 S Carbon Ave
Price, UT 84501-3226
Mailing address
453 S Carbon Ave
Price, UT 84501-3226
Phone (435) 650-0315
Other providers in Price, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.