Kerri Lee Bordelon, MSW, CSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11827522-3502 Issued in UT

Practice address

277 N Spring Creek Pkwy
Providence, UT 84332-9775

Phone

(435) 753-0253

NPI assigned

Jan 30, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1738195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1750194049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 S 1395 W",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843216979",
            "telephone_number": "214-662-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 N SPRING CREEK PKWY",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843329775",
            "telephone_number": "435-753-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDELON",
        "first_name": "KERRI",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "MSW, CSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "11827522-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lars Bergeson, M.D.
• Lyndsey Bergsjo, RBT
• Jaylee Berry
• Clara Blake, RBT
• Michael Bodrero, LCSW
• Allen Joshua Boyd, RBT
• Ben P Boyer, FNP
• Cheyanne J Bradshaw, RBT
• Cliffton K Brady, DC
• Brian T Lyman D C Inc

• Clinical Social Worker in Providence, UT
• Providers in Providence, 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 Jan 30, 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.