NPIMap

Organization Active NPI

Brookhaven Counseling

  • Clinical Social Worker
  • Lindon, UT
National Provider Identifier
1912599671
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BROOKHAVEN COUNSELING
Practice address
2578 W 600 N Suite 102
Lindon, UT 84042-2076
Phone
(801) 919-4854
NPI assigned
Feb 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Authorized official

Name
Mrs. Brooke Wily Ibanez, LCSWNPI 1659786747
Title
Owner/Therapist
Phone
(801) 919-4854

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2578 W 600 N Suite 102
Lindon, UT 84042-2076

Mailing address

2578 W 600 N Suite 102
Lindon, UT 84042-2076
Phone (801) 919-4854

National Provider Directory

National Provider Directory

Locations

2578 W 600 N
Ste 102
Lindon, UT 84042
Phone (385) 220-0770

821 N 900 W
Unit 304
Orem, UT 84057

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1912599671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2578 W 600 N SUITE 102",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840422076",
            "telephone_number": "801-919-4854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2578 W 600 N SUITE 102",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840422076",
            "telephone_number": "801-919-4854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKHAVEN COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-04",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "IBANEZ",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_middle_name": "WILY",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "801-919-4854",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindon, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.