MEDICARE: DAVID A. ALBRECHT 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	1071393501	UT

General Provider Information

NPI Number	:	1518055227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID A. ALBRECHT LCSW

Provider Business Mailing Address
First Line	:	132 S STATE ST
Second Line	:	SUITE 100
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84111-1506
Country	:	US
Telephone Number	:	801-240-6500
Fax Number	:	801-240-5508

Provider Business Practice Location Address
First Line	:	132 S STATE ST
Second Line	:	SUITE 100
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84111-1506
Country	:	US
Telephone Number	:	801-240-6500
Fax Number	:	801-240-5508

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	07/08/2007

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Directions to “ DAVID A. ALBRECHT LCSW” Practice Location

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