Bryan Manuel Acevedo
Individual provider Active NPI Clinical Social Worker · Salt Lake City, UT
NPI 1669068334 · NPPES record last updated Apr 2, 2024
Key facts
- NPI
- 1669068334
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 117 W 400 S
Salt Lake City, UT 84101-1916 - Phone
- (801) 428-4257
- NPI assigned
- Dec 17, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Yes |
Addresses
Primary practice location
117 W 400 S
Salt Lake City, UT 84101-1916
Mailing address
117 W 400 S
Salt Lake City, UT 84101-1916
Phone (801) 428-4257
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All providers in Salt Lake City, UT · Clinical Social Worker in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.