MEDICARE: NICOLE BURNARD MSW,CSW,LMT

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	225700000X	Massage Therapist	10439698-4701	UT
2	104100000X	Social Worker	10439698-3502	UT

General Provider Information

NPI Number	:	1831654235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE BURNARD MSW,CSW,LMT

Provider Business Mailing Address
First Line	:	4455 S 700 E STE 300
Second Line	:
City	:	MILLCREEK
State	:	UT
Zip	:	84107-3076
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4455 S 700 E STE 300
Second Line	:
City	:	MILLCREEK
State	:	UT
Zip	:	84107-3076
Country	:	US
Telephone Number	:	385-463-5005
Fax Number	:

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

Provider Enumeration Date	:	02/10/2019
Last Update Date	:	11/11/2024

Similar Medicare Providers

1013242569 — JUSTIN DENNIS VERRE L.AC.
Practice Location Address:

4455 S 700 E STE 300
MILLCREEK, UT
84107-3076

Practice Phone: 801-835-8269
Practice Fax:

1760185144 — 180 COUNSELING PLLC
Practice Location Address:

4455 S 700 E STE 201
MILLCREEK, UT
84107-3076

Practice Phone: 801-319-3666
Practice Fax:

1548996648 — PERSPECTIVE COUNSELING SERVICES LLC
Practice Location Address:

4455 S 700 E STE 300
SALT LAKE CITY, UT
84107-3076

Practice Phone: 385-246-1046
Practice Fax: 801-899-7793

1881457968 — STELLA DADGARI LCSW
Practice Location Address:

4455 S 700 E STE 300
SALT LAKE CITY, UT
84107-3076

Practice Phone: 385-202-0210
Practice Fax:

1770347882 — BRENNA MAIRIN BROOKS LCSW
Practice Location Address:

4455 S 700 E STE 300
SALT LAKE CITY, UT
84107-3076

Practice Phone: 385-246-1046
Practice Fax:

1235926874 — JACOB EZRA SEGURA LCSW
Practice Location Address:

4455 S 700 E STE 300
SALT LAKE CITY, UT
84107-3076

Practice Phone: 435-671-7819
Practice Fax:

Directions to “ NICOLE BURNARD MSW,CSW,LMT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.