Healthcare Provider Details
I. General information
NPI: 1912281585
Provider Name (Legal Business Name): AMY ENGLE BROTHERSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/30/2011
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
640 E 700 S STE 205
ST GEORGE UT
84770-5732
US
IV. Provider business mailing address
720 S RIVER RD STE B105
ST GEORGE UT
84790-5704
US
V. Phone/Fax
- Phone: 435-669-7109
- Fax: 435-359-4150
- Phone: 435-278-8227
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 7331860-3501 |
| License Number State | UT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: