Michael Douglas Brunson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

326545-2501 Issued in UT

Practice address

5691 S Redwood Rd Unit 15
Taylorsville, UT 84123-5485

Phone

(801) 971-0565

Fax

(801) 281-4083

NPI assigned

Feb 9, 2009

Last updated

Feb 9, 2009By the provider in NPPES

Sex

Male

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

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Associated Clinical & Counseling Psychologists

  • Clinical Psychologist
  • Taylorsville, UT
  • NPI 1679540751
  NPD (past)

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234137600000",
    "number": "1750520136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5691 S REDWOOD RD UNIT 15",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841235485",
            "telephone_number": "801-971-0565",
            "fax_number": "801-281-4083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5691 S REDWOOD RD UNIT 15",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841235485",
            "telephone_number": "801-971-0565",
            "fax_number": "801-281-4083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNSON",
        "first_name": "MICHAEL",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-09",
        "last_updated": "2009-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "326545-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Brown
• Tyler Brown
• Sierra Browning
• Kevyn Bruce
• Delsie Anne Bruehl
• Justice Bryant
• McKenna Elise Bryce
• Bo Mark Buchi, CMHC
• Carol Elaine Buffi, LCSW
• Jessica Bundy

• Clinical Psychologist in Taylorsville, UT
• Providers in Taylorsville, UT by specialty
• Clinical Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2009; 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.