Individual provider Active NPI

Brenda Ann Luker, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1770803421
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3492833501 Issued in UT
Practice address
925 Executive Park Dr Ste E
Salt Lake City, UT 84117-3542
Phone
(801) 631-8191
NPI assigned
Jun 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3492833501 UT Primary

Addresses

Primary practice location

925 Executive Park Dr Ste E
Salt Lake City, UT 84117-3542

Mailing address

925 Executive Park Dr Ste E
Salt Lake City, UT 84117-3542
Phone (801) 631-8191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3492833501UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275609600000",
    "number": "1770803421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 EXECUTIVE PARK DR STE E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841173542",
            "telephone_number": "801-631-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 EXECUTIVE PARK DR STE E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841173542",
            "telephone_number": "801-631-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKER",
        "first_name": "BRENDA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-04",
        "last_updated": "2010-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "3492833501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; 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.