Active NPI
Bryan Calvin Harrison, LCSW
- Clinical Social Worker
- Salt Lake City, UT
National Provider Identifier
1427196799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1790473501
- Practice address
- 4460 Highland Dr Ste 110
Salt Lake City, UT 84124-3543 - Phone
- (801) 273-4090
- NPI assigned
- Feb 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 1790473501 | UT | Primary |
Addresses
Primary practice location
4460 Highland Dr Ste 110
Salt Lake City, UT 84124-3543
Mailing address
4646 Atwood Blvd
Murray, UT 84107-3910
Phone (801) 232-6636
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17904735000001 | Other | UT | BLUE CROSS PROVIDER # |
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 |
|---|---|---|---|
| 1790473501 | UT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Mental Health Incorporated | Clinical | 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 and National Provider Directory roles.
-
- Geriatric Psychiatry Physician
- Salt Lake City, UT
- NPI 1366408874
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1427196799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4646 ATWOOD BLVD",
"city": "MURRAY",
"state": "UT",
"postal_code": "841073910",
"telephone_number": "801-232-6636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4460 HIGHLAND DR STE 110",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841243543",
"telephone_number": "801-273-4090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "BRYAN",
"middle_name": "CALVIN",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "1790473501",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER #",
"identifier": "17904735000001",
"state": "UT"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.