Brad Kelstrom, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7731529-3501 Issued in UT

Practice address

40 W Cache Valley Blvd Ste 10a
Logan, UT 84341-8450

Phone

(435) 787-2272

NPI assigned

Feb 26, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 23, 2020 through Sep 23, 2026

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 and National Provider Directory roles.

• Behavioral Mental Health Services, PC

  • Community/Behavioral Health Agency
  • Logan, UT
  • NPI 1558676239
  NPD (past)
• LDS Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Logan, UT
  • NPI 1801994132
  NPD (past)
• Paradise Creek Recovery Center Inc

  • Mental Health Counselor
  • Malta, ID
  • NPI 1629561139
  NPD (past)

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1396085486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W CACHE VALLEY BLVD STE 10A",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843418450",
            "telephone_number": "435-787-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 W CACHE VALLEY BLVD STE 10A",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843418450",
            "telephone_number": "435-787-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSTROM",
        "first_name": "BRAD",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-26",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "7731529-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas M Keele
• Melissa Keller Adamson, LCSW
• Kelly W Hubbard MD PC
• Ryan Kelly
• Kaitlin Kelsey, RD
• Daniel Gregory Kemp
• Kenya Kemp
• Samantha Kendall
• Keith Wesley Kent, DNP
• Jessica Kerby, CMHC

• Clinical Social Worker in Logan, UT
• Providers in Logan, 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 Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.