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)CodeLicenseStatePrimary
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

Other providers in Salt Lake City, UT

All providers in Salt Lake City, UT · Clinical Social Worker in Utah

Sources for this page

Verify at the official NPI Registry.