Healthcare Provider Details

I. General information

NPI: 1477290054
Provider Name (Legal Business Name): BRANDON CAMPBELL MS, MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2022
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7070 S UNION PARK AVE STE 150
MIDVALE UT
84047-6043
US

IV. Provider business mailing address

7070 S UNION PARK AVE STE 150
MIDVALE UT
84047-6043
US

V. Phone/Fax

Practice location:
  • Phone: 801-405-7540
  • Fax:
Mailing address:
  • Phone: 801-405-7450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: