FRED BROOKS (NPI# 1235694001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235694001 |
| Entity Type | Individual |
| Full Name | FRED BROOKS |
| Credential | M.ED; ED.S |
| Practice Address |
415 Medical Dr Ste D101 Bountiful UT 84010-8905 |
| Practice Telephone | 8016831062 |
| Practice Fax Number | 8012955537 |
| Mailing Telephone | 8016831062 |
| Mailing Fax Number | 8012955537 |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2019-02-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
692921 | UT | Behavioral Health & Social Service Providers |
| Street Address |
415 MEDICAL DR STE D101 |
| City | BOUNTIFUL |
| State | UT |
| Zip Code | 84010-8905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942260401 | Breanna R Nelson | Speech-Language Pathologist | 415 Medical Dr Ste D101, Bountiful, UT 84010-8905 | 2006-03-27 |
| 1114525862 | Candace Ann Abbott | Behavior Technician | 415 Medical Dr Ste D101, Bountiful, UT 84010-8905 | 2020-10-14 |
| 1083212930 | Breannen Cohen | Behavior Technician | 415 Medical Dr Ste D101, Bountiful, UT 84010-8905 | 2020-10-13 |
| 1376140798 | Laura Alicia Lucky | Counselor | 415 Medical Dr Ste D101, Bountiful, UT 84010-8905 | 2020-10-08 |
| 1639776693 | Taeko Michelle Colbert | Behavior Technician | 415 Medical Dr Ste D101, Bountiful, UT 84010-8905 | 2020-10-02 |
| 1699382887 | Anna L Straup | Behavior Technician | 415 Medical Dr Ste D101, Bountiful, UT 84010-8905 | 2020-09-30 |
| 1851903983 | Elaina M Grotepas | Behavior Technician | 415 Medical Dr Ste D101, Bountiful, UT 84010-8905 | 2020-08-19 |
| 1104437110 | Eden Deanne Steffey | Psychologist | 415 Medical Dr Ste D101, Bountiful, UT 84010-8905 | 2020-08-12 |
| 1891303111 | Molly Murphy Dwyer | Behavioral Analyst | 415 Medical Dr Ste D101, Bountiful, UT 84010-8905 | 2020-07-22 |
| 1972127728 | Benjamin Larsen | Behavior Technician | 415 Medical Dr Ste D101, Bountiful, UT 84010-8905 | 2020-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225699192 | Jessyca K Willie | Behavior Technician | 415 S. Medical Drive Suite D101, Bountiful, UT 84010 | 2019-06-21 |
| 1336634344 | Shanna Joy Jaggers | Social Worker | 2333 S 200 E, Bountiful, UT 84010 | 2018-06-22 |
| 1447773171 | Live Life Alarms | Emergency Response System Companies | 640 South 500 West, Bountiful, UT 84010 | 2017-07-25 |
| 1902328842 | Hailey Embley | Behavior Technician | 415 Medical Drive D 101, Bountiful, UT 84010 | 2017-07-12 |
| 1508318031 | Beverly Nielsen | Psychologist | 1001 Lakeview Drive, Bountiful, UT 84010 | 2016-11-01 |
| 1295287720 | Samantha Oslund | Speech-Language Pathologist | 415 Medical Dr Ste B102, Bountiful, UT 84010 | 2016-11-01 |
| 1750748273 | Jeremy Clark Morris | Dentist | 59 W 1600 N, Suite 110, Bountiful, UT 84010 | 2016-01-28 |
| 1629464706 | Shane James | Speech-Language Pathologist | 425 Medical Dr Ste 122, Bountiful, UT 84010 | 2015-04-15 |
| 1891186102 | Kenton Francis | Social Worker | 1355 North Main Street #1, Bountiful, UT 84010 | 2015-02-09 |
| 1205233855 | Modern Dental Professionals - Utah, PC | Dentist | 24 S. 500 West, #a, Bountiful, UT 84010 | 2014-11-25 |
| Find all providers in zip 84010 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104437110 | Eden Deanne Steffey | Psychologist | 415 Medical Dr Ste D101, Bountiful, UT 84010-8905 | 2020-08-12 |
| 1588200752 | Matthew Kirby | Psychologist | 415 Medical Dr Ste D101, Bountiful, UT 84010-8905 | 2019-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891275525 | Cynthia Mae Bolton | Psychologist | 1192 E Draper Parkway # 447, Draper, UT 84020 | 2018-08-21 |
| 1972089951 | Rebecca Lyn Walton | Psychologist | 442 W Bountiful Way, Saratoga Springs, UT 84045 | 2018-07-13 |
| 1477066124 | Kristen K Murdock | Psychologist | 1171 S 225 E, Orem, UT 84058-6975 | 2017-11-15 |
| 1013276559 | Ben Springer | Psychologist | 446 E 2010 S, Heber City, UT 84032-4457 | 2012-05-03 |
| 1841824281 | Michal Lynne Johnson | Psychologist | 9678 S 700 E Ste 102, Sandy, UT 84070-3593 | 2020-02-25 |
| 1225507908 | Jennifer Guthmann | Psychologist | 327 W Gordon Ave Ste 2, Layton, UT 84041-2381 | 2018-11-25 |
| 1689178071 | Marie Dian Foster | Psychologist | 5455 River Run Dr, Provo, UT 84604-7726 | 2018-03-20 |
| 1114462231 | Candice Lin Smith | Psychologist | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2016-12-28 |
| 1639474497 | Allison Jones | Psychologist | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2011-01-25 |
| 1851507057 | Pamela Swibel Plant | Psychologist | 1399 S 700 E, Suite 7, Salt Lake City, UT 84105-2149 | 2007-05-15 |
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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.