Active NPI
Rebecca Ann Brown, LSAC
- Clinical Social Worker
- Salt Lake City, UT
National Provider Identifier
1255638409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 350052-3502
- Practice address
- 5965 S 900 E
Salt Lake City, UT 84121-1720 - Phone
- (888) 949-4864
- NPI assigned
- Feb 24, 2011
- Last updated
- Aug 13, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 350052-6006 | UT | |
| Clinical Social Worker | 1041C0700X | 350052-3502 | UT | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
5965 S 900 E
Salt Lake City, UT 84121-1720
Mailing address
5965 S 900 E
Salt Lake City, UT 84121-1720
Phone (888) 949-4864
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 350052-6006 | UT | MD | Addiction (Substance Use Disorder) Counselor |
| 350052-3502 | UT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valleyfit Clinic LLC | Past | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376352000000",
"number": "1255638409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5965 S 900 E",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841211720",
"telephone_number": "888-949-4864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5965 S 900 E",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841211720",
"telephone_number": "888-949-4864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "REBECCA",
"middle_name": "ANN",
"credential": "LSAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-24",
"last_updated": "2013-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "UT",
"license": "350052-6006",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "350052-3502",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.