Individual provider Active NPI

Meagan Lavelle Brooks, CSW

  • Clinical Social Worker
  • Orem, UT
National Provider Identifier
1124684709
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11256803-3502 Issued in UT
Practice address
36 S 400 W Ste 102
Orem, UT 84058-5359
Phone
(801) 251-6884
NPI assigned
May 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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 11256803-3502 UT Primary

Addresses

Primary practice location

36 S 400 W Ste 102
Orem, UT 84058-5359

Mailing address

36 S 400 W Ste 102
Orem, UT 84058-5359
Phone (801) 251-6884

Other identifiers 1

IdentifierTypeStateIssuer
11256803-3502OtherUTDOPL LICENSING NUMBER

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11256803-3502UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1558224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1124684709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 S 400 W STE 102",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840585359",
            "telephone_number": "801-251-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 S 400 W STE 102",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840585359",
            "telephone_number": "801-251-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "MEAGAN",
        "middle_name": "LAVELLE",
        "name_prefix": "Mrs.",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-19",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "11256803-3502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOPL LICENSING NUMBER",
            "identifier": "11256803-3502",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.