MEDICARE: MR. RENE ELIAS BARRERA 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
1	1041C0700X	Clinical Social Worker	7447256-3501	UT

General Provider Information

NPI Number	:	1184688012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RENE ELIAS BARRERA LCSW

Provider Business Mailing Address
First Line	:	8813 S REDWOOD RD STE B1
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84088-9272
Country	:	US
Telephone Number	:	385-439-9823
Fax Number	:

Provider Business Practice Location Address
First Line	:	8813 S REDWOOD RD STE B1
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84088-9272
Country	:	US
Telephone Number	:	385-439-9823
Fax Number	:

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

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	03/06/2026

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