Talaisha Bracken, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6124913-3501 Issued in UT

Practice address

25 N 100 E Ste 102
St George, UT 84770-7369

Phone

(435) 986-2565

NPI assigned

Mar 23, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Utah Community Health CenterGroup PAC ID 5799692398, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Southwest Utah Community Health Center

  • Federally Qualified Health Center (FQHC)
  • St George, UT
  • NPI 1659358687
  Medicare reassignment Care Compare group
• Southwest Utah Community Health Center

  • Clinic/Center
  • Cedar City, UT
  • NPI 1073988077
  NPD
• Southwest Utah Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Hurricane, UT
  • NPI 1780090944
  NPD (past)

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1235405259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N 100 E STE 102",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847707369",
            "telephone_number": "435-986-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N 100 E STE 102",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847707369",
            "telephone_number": "435-986-2565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 West 700 South",
            "address_purpose": "LOCATION",
            "city": "Ephraim",
            "state": "UT",
            "postal_code": "84627",
            "country_code": "US",
            "telephone_number": "801-375-4240",
            "fax_number": "801-375-4241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRACKEN",
        "first_name": "TALAISHA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-23",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "6124913-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nellie Jane Boyer, CCC-SLP
• Ron Dell Boyer, D.C.
• Jamey Bracken
• Lamar Bracken, DVM
• Rebekah Leigh Bracken, FNP-C
• Alana Jeanne Bradbury, NP
• Matthew Eugene Bradbury, D.O.
• Justin David Brader, BC-HIS
• Lawrence Bradley, LMFT
• Mason Bradley

• Clinical Social Worker in St George, UT
• Providers in St George, 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 Jun 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.