Individual provider Active NPI

Brynn Celestino, CSW

  • Clinical Social Worker
  • Provo, UT
National Provider Identifier
1891358032
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11770884-3502 Issued in UT
Practice address
1530 S 500 W
Provo, UT 84601-6014
Phone
(801) 669-5861
Fax
(801) 669-5889
NPI assigned
Apr 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11770884-3502 UT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1530 S 500 W
Provo, UT 84601-6014

Mailing address

51 S 800 W
Provo, UT 84601-4055
Phone (435) 849-6189

Other practice location 1

2450 E Fort Union Blvd
Salt Lake City, UT 84121-3337
Phone (801) 669-5888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Aug 25, 2025 through Aug 25, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11770884-3502UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New Roads Foundation Clinical PastSince Apr 11, 2021 Accepting new patients
Hilltop Medical Clinic, LLC Past Accepting new patients
DBT Network of Utah Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1891358032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 S 800 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846014055",
            "telephone_number": "435-849-6189",
            "fax_number": "801-669-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 S 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846016014",
            "telephone_number": "801-669-5861",
            "fax_number": "801-669-5889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 E Fort Union Blvd",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841213337",
            "country_code": "US",
            "telephone_number": "801-669-5888",
            "fax_number": "801-669-5889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CELESTINO",
        "first_name": "BRYNN",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-14",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "11770884-3502",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.