Active NPI
Kayce C Bradley
- Clinical Social Worker
- Logan, UT
National Provider Identifier
1508340357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11587627-3501
- Practice address
- 965 S 100 W Ste 106
Logan, UT 84321-6067 - Phone
- (435) 554-1119
- NPI assigned
- Sep 18, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 11587627-3501 | UT | Primary |
Addresses
Primary practice location
965 S 100 W Ste 106
Logan, UT 84321-6067
Mailing address
911 W 2840 S
Nibley, UT 84321-6522
Phone (801) 388-3981
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 990177601002 | Medicaid | UT |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11587627-3501 | UT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guiding Light Mental Health and Wellness | Clinical | Current | Accepting new patients |
Locations
965 S 100 W
Ste 106
Logan, UT 84321
Phone (435) 554-1119
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752624000000",
"number": "1508340357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "911 W 2840 S",
"city": "NIBLEY",
"state": "UT",
"postal_code": "843216522",
"telephone_number": "801-388-3981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "965 S 100 W STE 106",
"city": "LOGAN",
"state": "UT",
"postal_code": "843216067",
"telephone_number": "435-554-1119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "KAYCE",
"middle_name": "C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-18",
"last_updated": "2025-07-16",
"certification_date": "2025-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "11587627-3501",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "990177601002",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.