MR. DOUGLAS BOWEN BRUNKER (NPI# 1154306421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154306421 |
| Entity Type | Individual |
| Full Name | MR. DOUGLAS BOWEN BRUNKER |
| Credential | LCSW |
| Practice Address |
780 Guardsman Way Salt Lake City UT 84108-1374 |
| Mailing Address |
44 W Broadway Apt 1008 Salt Lake City UT 84101-3210 |
| Practice Telephone | 8015810194 |
| Practice Fax Number | 8015810193 |
| Mailing Telephone | 8015810194 |
| Mailing Fax Number | 8015810193 |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
1401633501 | UT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | EDUCATORS MUTUAL | 942938348BR1 | 01 |
| UT | INTRMTN. HEALTH CARE | 107032396101 | 01 |
| UT | DESERET MUTUAL | 261871 | 01 |
| Street Address |
780 GUARDSMAN WAY |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84108-1374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750641981 | Joclynn Rowley | Counselor | 780 Guardsman Way, Salt Lake City, UT 84108-1374 | 2012-05-22 |
| 1245590470 | Madeline Vandever | Counselor | 780 Guardsman Way, Salt Lake City, UT 84108-1374 | 2012-05-22 |
| 1780941435 | Michele Orphanakis | Counselor | 780 Guardsman Way, Salt Lake City, UT 84108-1374 | 2012-04-19 |
| 1720386238 | Megan Requadt | Counselor | 780 Guardsman Way, Salt Lake City, UT 84108-1374 | 2011-03-08 |
| 1194023861 | Caryn Delayn Wehmeyer | Counselor | 780 Guardsman Way, Salt Lake City, UT 84108-1374 | 2011-03-04 |
| 1487952131 | Lisa Sorensen | Counselor | 780 Guardsman Way, Salt Lake City, UT 84108-1374 | 2011-03-04 |
| 1114225851 | Joseph Francis Russo | Counselor | 780 Guardsman Way, Salt Lake City, UT 84108-1374 | 2011-03-04 |
| 1760780423 | Jason Lee Mair | Counselor | 780 Guardsman Way, Salt Lake City, UT 84108-1374 | 2011-03-04 |
| 1326346073 | Teresa K Embleton | Counselor | 780 Guardsman Way, Salt Lake City, UT 84108-1374 | 2011-03-04 |
| 1700184488 | Lucy Thach | Counselor | 780 Guardsman Way, Salt Lake City, UT 84108-1374 | 2011-03-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548753056 | Maxine Ht Erickson | Assistant Behavior Analyst | 780 Guardsman Way, Salt Lake City, Ut 84108, Salt Lake City, USA 84108 | 2018-06-08 |
| 1841704061 | Robyn Carver | Occupational Therapist | 421 Wakara Wat, Salt Lake City, UT 84108 | 2017-11-27 |
| 1518478742 | Lcr Dental Sugar House | Dentist | 2068 S 2100 E Suite #a, Salt Lake City, UT 84108 | 2017-10-16 |
| 1447708912 | Aubrianne Squire Evans | Occupational Therapist | 421 S Wakara Way Ste 201, Salt Lake City, UT 84108 | 2016-09-14 |
| 1629524426 | Ryan Weisenbeck | Specialist/Technologist | 580 S Guardsman Way, Salt Lake City, UT 84108 | 2016-08-31 |
| 1164885547 | Michael Fazzone | Student in an Organized Health Care Education/Training Program | 530 South Wakara Way, University of Urah, School of Dentistry, Salt Lake City, UT 84108 | 2016-04-01 |
| 1669833489 | Bryon Claflin | Registered Nurse | 650 S Komas Ste 200, Salt Lake City, UT 84108 | 2016-03-08 |
| 1801283833 | Autism Assement Treatment Program Adult | Psychologist | 650 S Komas, Suite 200, Salt Lake City, UT 84108 | 2015-04-16 |
| 1578993275 | Matthew and David Dental Pllc | Dentist | 1355 Foothill Drive, Salt Lake City, UT 84108 | 2013-11-15 |
| 1841631520 | Deepika Garg | Internal Medicine | 675 S Arapeen Dr Ste 205, Salt Lake City, UT 84108 | 2013-07-10 |
| Find all providers in zip 84108 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606763 | Eric Jeffrey Hales | Social Worker | 352 S Denver St Ste 350, Salt Lake City, UT 84111-3059 | 2020-10-14 |
| 1700490067 | Open Arms Youth and Adult Services | Social Worker | 3007 S West Temple Ste J, Salt Lake City, UT 84115-6701 | 2020-09-03 |
| 1275147019 | Libby Rae Hughes | Social Worker | 1170 S Foothill Dr Apt 323, Salt Lake City, UT 84108-1955 | 2020-08-31 |
| 1881206910 | Christine Madden | Social Worker | 699 E South Temple Ste 300a, Salt Lake City, UT 84102-1188 | 2020-08-19 |
| 1003428566 | Laura Marie Baumgart | Social Worker | 1390 S 1100 E Ste 204, Salt Lake City, UT 84105-2463 | 2020-08-17 |
| 1851901193 | Angelique Colemere | Social Worker | 1399 S 700 E Ste 16, Salt Lake City, UT 84105-2170 | 2020-08-02 |
| 1871102095 | Aimee Hadfield | Social Worker | Hearten House, 314 W. Broadway #222, Salt Lake City, UT 84109 | 2020-07-23 |
| 1619586856 | Layne Gerry Daybell | Social Worker | 136 E South Temple, Salt Lake City, UT 84111-1180 | 2020-07-23 |
| 1043829328 | Christopher Wesley Pace | Social Worker | 2000 Circle of Hope Dr Rm 2840, Salt Lake City, UT 84112-5550 | 2020-07-23 |
| 1962028795 | Amy Lynn Horyna | Social Worker | 1950 Circle of Hope Dr Rm 2935, Salt Lake City, UT 84112-5500 | 2020-06-17 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84108 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.