Gary V Broadbent, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

113385-3501 Issued in UT

Practice address

5030 Harrison Blvd
Ogden, UT 84403-4311

Phone

(801) 550-6712

NPI assigned

Dec 3, 2008

Last updated

Dec 3, 2008By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228262400000",
    "number": "1497990550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2757 E 3600 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841093546",
            "telephone_number": "801-550-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844034311",
            "telephone_number": "801-550-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADBENT",
        "first_name": "GARY",
        "middle_name": "V",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-03",
        "last_updated": "2008-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "113385-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brighter Ground Therapy PLLC
• Kortnee Sandra Brightshue
• Heather Brinkerhoff
• Kelly Jean Brinkerhoff, NURSE PRACTITIONER
• Bristol Hospice - Utah, L.L.C.
• Jeffrey P Broadbent, DMD
• Michael William Broadbent, DMD, M.S.
• Melanie Ann Broadhead
• Mark Steven Broccardo, COTA
• Raymond Donald Brock, CPSS

• Clinical Social Worker in Ogden, UT
• Providers in Ogden, 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 Dec 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.