DR. LAURA LYN BROCKBANK


Address: 1399 S 700 E, Suite 7, Salt Lake City, UT 84105-2149
Phone: 8014833068

DR. LAURA LYN BROCKBANK (NPI# 1780720888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1780720888
Entity Type Individual
Full Name DR. LAURA LYN BROCKBANK
Credential PH.D.
Practice Address 1399 S 700 E
Suite 7
Salt Lake City
UT 84105-2149
Mailing Address 1966 Lincoln Ln
Salt Lake City
UT 84124-2745
Practice Telephone 8014833068
Practice Fax Number 8014833072
Mailing Telephone 8012781139
Enumeration Date 2007-01-29
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC2200X Psychologist
Specialization: Clinical Child & Adolescent
363425-2501 UT Behavioral Health & Social Service Providers

Office Location

Street Address 1399 S 700 E
SUITE 7
City SALT LAKE CITY
State UT
Zip Code 84105-2149

Providers in the same location

NPI Name Taxonomy Address Enumeration
1720066442 Debra Marie Quackenbush Psychologist 1399 S 700 E, Salt Lake City, UT 84105-2160 2006-01-03
1396133815 Kellie Clement Social Worker 1399 S 700 E, Suite 1, Salt Lake City, UT 84105-2149 2015-01-06
1477837573 Jason Durtschi Social Worker 1399 S 700 E, Salt Lake City, UT 84105-2149 2011-10-06
1376737676 James M Struve Inc Social Worker 1399 S 700 E, Suite #2, Salt Lake City, UT 84105-2149 2007-08-29
1851583702 Jeffrey Alan Bell Social Worker 1399 S 700 E, Suite 1, Salt Lake City, UT 84105-2149 2007-08-14
1013111996 Charlotte J Ferrin Psychologist 1399 S 700 E, Suite 11, Salt Lake City, UT 84105-2149 2007-06-13
1043429749 Kevin Del Lambert Psychiatry & Neurology 1399 S 700 E, Suite 5b, Salt Lake City, UT 84105-2149 2007-05-21
1851507057 Pamela Swibel Plant Psychologist 1399 S 700 E, Suite 7, Salt Lake City, UT 84105-2149 2007-05-15
1235344763 Kenneth L. Critchfield II Psychologist 1399 S 700 E, #9, Salt Lake City, UT 84105-2149 2007-05-10
1861613853 Gary Joel Klein Social Worker 1399 S 700 E, Suite 11b, Salt Lake City, UT 84105-2149 2007-05-01
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1285106237 Laiyan H Bawadeen Counselor 1425 700 E Suite #102, Salt Lake City, UT 84105 2018-12-31
1639644255 Claire Elizabeth Gray Marriage & Family Therapist 1425 700 East, Salt Lake City, UT 84105 2018-10-10
1083089643 Celisa Packer Social Worker 2020 E Lake St, Salt Lake City, UT 84105 2015-12-08
1083052963 Christina Elizabeth Burton Nurse Practitioner 1008 S 1100 E, Apt 6, Salt Lake City, UT 84105 2013-06-12
1649548355 Leland Burt Cowan Surgery 1405 Princeton Ave, Salt Lake City, UT 84105 2011-12-08
1639460355 Sally Cathleen Webster Counselor 1248 Yale Avenue, Salt Lake City, UT 84105 2011-04-28
1912205105 Melissa Wilson Case Manager/Care Coordinator 1522 S 1100 E, Salt Lake City, UT 84105 2011-03-11
1013215789 Tamara Marie Wright Counselor 1996 Lake St, Salt Lake City, UT 84105 2011-03-04
1144527243 Crystal Nicole Garduno Counselor 1522 South 1100 East, Salt Lake City, UT 84105 2011-02-25
1508011180 Keith Elliott Anesthesiology 1552 South 1000 East, Salt Lake City, UT 84105 2008-11-24
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Taxonomy Information

Taxonomy Code 103TC2200X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical Child & Adolescent

Taxonomy Definition

Definition to come...
Notes: [1/1/2007: title modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1477913762 Lisa Daniels Psychologist 4568 S Highland Dr Ste 260b, Salt Lake City, UT 84117-4236 2016-02-29
1386945566 Annie Michol Deming Psychologist 5770 S 1500 W # G, Salt Lake City, UT 84123-5216 2010-11-04
1588829634 Carla J Reyes Psychologist 4568 S Highland Dr Ste 100, Salt Lake City, UT 84117-4234 2008-07-28
1265592083 Fenster Corp. Psychologist 4505 Wasatch Blvd Ste 380, Salt Lake City, UT 84124-4733 2006-12-11
1174625016 Donald Emory Beck Psychologist 44 Medical Dr, Salt Lake City, UT 84132-0001 2006-09-01
1376570820 Douglas Frank Goldsmith Psychologist 5383 S 900 E Ste 290, Salt Lake City, UT 84117-7268 2006-06-27
1457808370 Jennifer Wehan Psychologist 350 S 400 E, Salt Lake City, UT 84111-2905 2016-09-08
1386016061 Renee Kathleen Burke Psychologist 1945 S 1100 E, Suite 206, Salt Lake City, UT 84106-2369 2015-10-21
1346637881 Natalie Buerger Psychologist 295 S Chipeta Way, Salt Lake City, UT 84108-1287 2015-04-22
1568864114 Amanda Aulbaugh Psychologist 350 S 400 E, Salt Lake City, UT 84111-2908 2014-09-25
Find all providers in SALT LAKE CITY

Competitor

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City SALT LAKE CITY
Zip Code 84105

Improve Information

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Dataset Information

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.

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