Individual provider Active NPI

Tara Bravo

  • Clinical Social Worker
  • Taylorsville, UT
National Provider Identifier
1457888125
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
849 W Levoy Dr Ste 108
Taylorsville, UT 84123-2599
Phone
(801) 405-7450
Fax
(385) 446-2650
NPI assigned
May 12, 2017
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

849 W Levoy Dr Ste 108
Taylorsville, UT 84123-2599

Mailing address

849 W Levoy Dr Ste 108
Taylorsville, UT 84123-2599
Phone (801) 405-7450

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191119000438 UT Practitioner - Clinical Social Worker 4789016460 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Davis Behavioral Health Inc CurrentSince Sep 18, 2019 Accepting new patients
Lotus Center Inc CurrentSince May 18, 2025 Accepting new patients
Lotus Center Inc CurrentSince May 12, 2022 Accepting new patients

Locations

2250 N Robins Dr
Layton, UT 84041
Phone (801) 779-3001

934 S Main St
Layton, UT 84041
Phone (801) 336-1845

4376 S 700 E
Ste 200
Salt Lake City, UT 84107
Phone (385) 272-4292

Organizations & group practices 4

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": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1457888125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 W LEVOY DR STE 108",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841232599",
            "telephone_number": "801-405-7450",
            "fax_number": "385-446-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 W LEVOY DR STE 108",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841232599",
            "telephone_number": "801-405-7450",
            "fax_number": "385-446-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO",
        "first_name": "TARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-12",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylorsville, UT

Sources for this page

Verify at the official NPI Registry.