Douglas Bowen Brunker, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1401633501 Issued in UT

Practice address

780 Guardsman Way
Salt Lake City, UT 84108-1374

Phone

(801) 581-0194

Fax

(801) 581-0193

NPI assigned

Dec 9, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Valley Behavioral Health Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Valley City, UT
  • NPI 1932166980

  Clinical

  NPD (past)
• Valley Mental Health Incorporated

  • Child & Adolescent Psychiatry Physician
  • Salt Lake City, UT
  • NPI 1154387678

  Clinical

  NPD (past)

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154306421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 W BROADWAY APT 1008",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841013210",
            "telephone_number": "801-581-0194",
            "fax_number": "801-581-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 GUARDSMAN WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081374",
            "telephone_number": "801-581-0194",
            "fax_number": "801-581-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNKER",
        "first_name": "DOUGLAS",
        "middle_name": "BOWEN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "1401633501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL",
            "identifier": "261871",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTRMTN. HEALTH CARE",
            "identifier": "107032396101",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATORS MUTUAL",
            "identifier": "942938348BR1",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ross A. Brunetti, M.D.
• Emily Bruni, PHARM D
• Jeanette Brunisholz
• Sylvia Brunisholz
• Cherie Pratt Brunker, MD
• Alicia Brunner
• Ann Bruno, MD
• Kaylee Bruno, FNP-S
• Rex Lenard Brunsdale
• Vickie L Brunstetter, O.T.

• Clinical Social Worker in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.