Individual provider Active NPI

Brandon Jay Johnson, LCSW

  • Clinical Social Worker
  • South Jordan, UT
National Provider Identifier
1497419501
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8603913-3501 Issued in UT
Practice address
10808 S River Front Pkwy Ste 352
South Jordan, UT 84095-5761
Phone
(801) 471-4585
NPI assigned
Oct 25, 2021
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 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 8603913-3501 UT Primary

Addresses

Primary practice location

10808 S River Front Pkwy Ste 352
South Jordan, UT 84095-5761

Mailing address

10808 S River Front Pkwy Ste 352
South Jordan, UT 84095-5761
Phone (801) 471-4585

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
I20240412001019 UT Practitioner - Clinical Social Worker 0648619429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Utah School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10808 S River Front Pkwy
Suite 352
South Jordan, UT 84095-6100
Phone (801) 984-6881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8603913-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mulligan Counseling Services, PLLC Clinical CurrentSince Feb 14, 2024 Accepting new patients

Locations

10808 S River Front Pkwy
Ste 352
South Jordan, UT 84095
Phone (704) 886-4075

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": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1497419501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10808 S RIVER FRONT PKWY STE 352",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955761",
            "telephone_number": "801-471-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10808 S RIVER FRONT PKWY STE 352",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955761",
            "telephone_number": "801-471-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRANDON",
        "middle_name": "JAY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-25",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "8603913-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

Verify at the official NPI Registry.