Active NPI
Jacob Holbrook
- Clinical Social Worker
- Layton, UT
National Provider Identifier
1225413586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6967058-3503
- Practice address
- 934 S Main St
Layton, UT 84041-7135 - Phone
- (801) 773-7060
- NPI assigned
- Jul 28, 2015
- Last updated
- Nov 15, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6967058-3503 | UT | Primary |
Addresses
Primary practice location
934 S Main St
Layton, UT 84041-7135
Mailing address
5125 S 1500 W
Riverdale, UT 84405-3926
Phone (801) 719-7603
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225413586 | Other | UT | PRIVATE PRACTICE NON MEDICAID |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6967058-3503 | UT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holbrook Behavioral Counseling LLC | Clinical | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Riverdale, UT
- NPI 1063251064
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668470400000",
"number": "1225413586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5125 S 1500 W",
"city": "RIVERDALE",
"state": "UT",
"postal_code": "844053926",
"telephone_number": "801-719-7603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "934 S MAIN ST",
"city": "LAYTON",
"state": "UT",
"postal_code": "840417135",
"telephone_number": "801-773-7060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLBROOK",
"first_name": "JACOB",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-28",
"last_updated": "2022-11-15",
"certification_date": "2022-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "6967058-3503",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIVATE PRACTICE NON MEDICAID",
"identifier": "1225413586",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Layton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.