Active NPI
Brenda Sturdevant
- Social Worker
- Moab, UT
National Provider Identifier
1336480920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 9753121-3503
- Practice address
- 59 N. 200 E.
Moab, UT 84532 - Phone
- (435) 259-7340
- Fax
- (435) 678-3116
- NPI assigned
- Mar 7, 2013
- Last updated
- Jul 19, 2021
- 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 |
|---|---|---|---|---|
| Other Technician | 247200000X | NU | ||
| Social Worker | 104100000X | 9753121-3503 | UT | Primary |
| Case Manager/Care Coordinator | 171M00000X | NU |
Addresses
Primary practice location
59 N. 200 E.
Moab, UT 84532
Mailing address
P.O. Box 867
Price, UT 84501-0867
Phone (435) 637-7200
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 |
|---|---|---|---|
| 9753121-3503 | UT | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Juan Mental Health-Substance Abuse Special Service District | Past | Accepting new patients | |
| San Juan Mental Health-Substance Abuse SSD | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba San Juan Counseling
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Blanding, UT
- NPI 1356353692
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Blanding, UT
- NPI 1790898526
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626652800000",
"number": "1336480920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 867",
"city": "PRICE",
"state": "UT",
"postal_code": "845010867",
"telephone_number": "435-637-7200",
"fax_number": "435-678-3116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "59 N. 200 E.",
"city": "MOAB",
"state": "UT",
"postal_code": "84532",
"telephone_number": "435-259-7340",
"fax_number": "435-678-3116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STURDEVANT",
"first_name": "BRENDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-07",
"last_updated": "2021-07-19",
"certification_date": "2021-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "UT",
"license": "9753121-3503",
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moab, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.