Brooke Wily Ibanez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

52622313502 Issued in UT

Practice address

2578 W 600 N Ste 102
Lindon, UT 84042-1260

Phone

(385) 220-0770

Fax

(385) 900-1637

NPI assigned

Jun 26, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Brooke Ibanez Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Brookhaven Counseling

  • Clinical Social Worker
  • Lindon, UT
  • NPI 1912599671
  NPD Authorized official

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1659786747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "552 N 1540 W",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840422076",
            "telephone_number": "801-919-4854",
            "fax_number": "385-900-1637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2578 W 600 N STE 102",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840421260",
            "telephone_number": "385-220-0770",
            "fax_number": "385-900-1637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBANEZ",
        "first_name": "BROOKE",
        "middle_name": "WILY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "52622313502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "IBANEZ",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Weston Thorpe Harris, BC-HIS
• Kazuyoshi Hayashi, LCSW
• Scott M Healey, D.M.D
• Siera Michelle Heaton
• Her Haven Collective PLLC
• Isabel Paola Jackman, NP
• Michelle Jaramillo
• Adrienne Manina Jaynes, LCSW
• Sandra Raymond Jensen, PH.D.
• Kenneth Hal Johnson, PHARMD

• Clinical Social Worker in Lindon, UT
• Providers in Lindon, 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 Mar 14, 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.

Verify at the official NPI Registry.