Individual provider Active NPI

Brandice Sonderegger, CSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1790180008
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
64196203502 Issued in UT
Practice address
450 S 900 E
Suite 300
Salt Lake City, UT 84102-2981
Phone
(801) 587-2770
NPI assigned
Oct 29, 2014
Last updated
Oct 29, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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 64196203502 UT Primary

Addresses

Primary practice location

450 S 900 E
Suite 300
Salt Lake City, UT 84102-2981

Mailing address

6951 S Boulder Dr
Cottonwood Heights, UT 84121-6623
Phone (801) 750-9587

Other names 1

  • Brandice Porter Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
64196203502UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1790180008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6951 S BOULDER DR",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841216623",
            "telephone_number": "801-750-9587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S 900 E",
            "address_2": "SUITE 300",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022981",
            "telephone_number": "801-587-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONDEREGGER",
        "first_name": "BRANDICE",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-29",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "64196203502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDICE",
            "last_name": "PORTER",
            "credential": "CSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Oct 29, 2014; 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.