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NPI Code Detail

MEDICARE: BRIAN J. WHIPPLE LCSW

MEDICARE: BRIAN J. WHIPPLE LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker124301-3501UT

General Provider Information

NPI Number : 1154359651
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN J. WHIPPLE LCSW
Provider Business Mailing Address
First Line : 255 W MAIN ST
Second Line :
City : MT PLEASANT
State : UT
Zip : 84647-1331
Country : US
Telephone Number : 435-462-2416
Fax Number : 435-462-9350
Provider Business Practice Location Address
First Line : 390 W 1ST N
Second Line :
City : EPHRAIM
State : UT
Zip : 84627-2131
Country : US
Telephone Number : 435-283-4065
Fax Number : 435-283-5387
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2006
Last Update Date : 07/09/2007

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