BRADLEY PEDERSEN (NPI# 1538477187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538477187 |
| Entity Type | Individual |
| Full Name | BRADLEY PEDERSEN |
| Practice Address |
340 E 100 S Salt Lake City UT 84111-1702 |
| Mailing Address |
11651 Mapleberry Ct Draper UT 84020-6858 |
| Practice Telephone | 8013223222 |
| Mailing Telephone | 8015992405 |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2010-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Street Address |
340 E 100 S |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84111-1702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033143706 | Odyssey House Inc. | Clinic/Center | 340 E 100 S, Salt Lake City, UT 84111-1702 | 2006-07-10 |
| 1730788084 | Braden Price | Case Manager/Care Coordinator | 340 E 100 S, Salt Lake City, UT 84111-1702 | 2020-10-19 |
| 1316500754 | Chloe Lorraine Maddox | Case Manager/Care Coordinator | 340 E 100 S, Salt Lake City, UT 84111-1702 | 2019-04-22 |
| 1922573633 | Stephanie Wheatley | Nurse Practitioner | 340 E 100 S, Salt Lake City, UT 84111-1836 | 2018-10-09 |
| 1750829743 | Krista Eger | Community Health Worker | 340 E 100 S, Ste 301, Salt Lake City, UT 84111-1702 | 2017-02-09 |
| 1164856886 | Chad Ryan Rebo | Physician Assistant | 340 E 100 S, Salt Lake City, UT 84111-1702 | 2013-08-29 |
| 1356612790 | Myles Davis | Counselor | 340 E 100 S, Salt Lake City, UT 84111-1702 | 2012-01-17 |
| 1780960153 | Robert Price | Counselor | 340 E 100 S, Salt Lake City, UT 84111-1702 | 2011-10-28 |
| 1164739454 | Hayley L Mcmillan | Counselor | 340 E 100 S, Salt Lake City, UT 84111-1702 | 2010-09-08 |
| 1588985238 | Odyssey House of Utah | Substance Abuse Rehabilitation Facility | 340 E 100 S, Salt Lake City, UT 84111-1702 | 2010-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316551336 | Mary Ann Rush | Case Manager/Care Coordinator | 334 E. 100 S., Slc, UT 84111 | 2020-09-08 |
| 1790396554 | Stephanie G Mishenko | Military Health Care Provider | 344e 100s, Slc, UT 84111 | 2020-08-13 |
| 1386264802 | Mckensee M Carter | Case Manager/Care Coordinator | 334 E 100 S, Salt Lake City, UT 84111 | 2020-04-24 |
| 1316421761 | Community Health Centers, Inc. | Social Worker | 610 S 200 E Ste #b, Salt Lake City, UT 84111 | 2018-09-21 |
| 1528545506 | Lauren Brittney Harman | Case Manager/Care Coordinator | 344 E. 100 S., Salt Lake City, UT 84111 | 2018-07-23 |
| 1851896484 | Shivani Chowdhary | Dentist | 370 E South Temple Ste 350, Salt Lake City, UT 84111 | 2018-03-26 |
| 1801390661 | Jaylee Marie Watman | Case Manager/Care Coordinator | 344 E. 100 S. Ste 301, Salt Lake City, UT 84111 | 2018-03-19 |
| 1467963918 | Victoira Julia Graham | Case Management | 344 East 100 South Ste 301, Salt Lake City, UT 84111 | 2017-10-23 |
| 1750805404 | Kayla Hymas | Behavioral Analyst | 243 E. 400 S., Slc, UT 84111 | 2017-08-02 |
| 1134643224 | Julie Peaslee | Counselor | 275 E South Temple Ste 110, Salt Lake City, UT 84111 | 2017-07-31 |
| Find all providers in zip 84111 | ||||
| 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 | 84111 |
Please comment or provide details below to improve the information on BRADLEY PEDERSEN.
| 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.