Individual provider Active NPI

Kristi Brown, CSW

  • Clinical Social Worker
  • Layton, UT
National Provider Identifier
1629434428
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11789997-3506 Issued in UT
Practice address
934 S Main St
Layton, UT 84041-7135
Phone
(801) 773-7060
NPI assigned
Jan 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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 11789997-3506 UT Primary

Addresses

Primary practice location

934 S Main St
Layton, UT 84041-7135

Mailing address

934 S Main St
Layton, UT 84041-7135
Phone (801) 773-7060

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
I20260519004317 UT Practitioner - Clinical Social Worker 0648752642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4626 S 2950
Roy, UT 84067-8977

4645 Midland Dr
Suite 2
West Haven, UT 84401-6824

4645 Midland Dr
Suite 2
West Haven, UT 84401-6825

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11789997-3506UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Mindset 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.

NPI Registry JSON

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

{
    "created_epoch": "1452211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1629434428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 S MAIN ST",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417135",
            "telephone_number": "801-773-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 S MAIN ST",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417135",
            "telephone_number": "801-773-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KRISTI",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-08",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "11789997-3506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.