Weston Fredman, CSW, CASUDC
Individual provider Active NPI Social Worker · Millcreek, UT
NPI 1871273151 · NPPES record last updated Jul 20, 2023
Key facts
- NPI
- 1871273151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 12685832-3502 (UT)
- Practice address
- 4905 S 900 E
Millcreek, UT 84117-5703 - Phone
- (801) 869-1095
- NPI assigned
- Jul 20, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12685832-3502 | UT | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BRC Outpatient LLC | Current |
Accepting new patients | |
| Brighton Medical Group | Current |
Accepting new patients |
Locations
4905 S 900 E
Murray, UT 84117
Phone (801) 865-1095
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 12685832-3502 | UT | Yes |
Addresses
Primary practice location
4905 S 900 E
Millcreek, UT 84117-5703
Mailing address
12021 S Nicklaus Rd
Sandy, UT 84092-5903
Phone (801) 834-9943
Other providers in Millcreek, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.