MEDICARE: DENISE EILEEN BROOKS MS

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
1	1041C0700X	Clinical Social Worker	8349036-3501	UT

General Provider Information

NPI Number	:	1164781852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE EILEEN BROOKS MS

Provider Business Mailing Address
First Line	:	7265 S 1950 E #26
Second Line	:
City	:	SLC
State	:	UT
Zip	:	84121-4875
Country	:	US
Telephone Number	:	801-750-4108
Fax Number	:

Provider Business Practice Location Address
First Line	:	4460 S HIGHLAND DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84124-3543
Country	:	US
Telephone Number	:	888-949-4864
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2012
Last Update Date	:	06/03/2026

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