NPI 1275428302 · live from the CMS NPI Registry
Tyler Anderson, CSW
Social Worker in Logan, UT. National Provider Identifier 1275428302, active.
NPI record
| NPI | 1275428302 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker 104100000X |
| Practice location | 1515 N 400 E Ste 104, Logan, UT 84341 |
| Practice phone | 208-232-7862 |
| Mailing address | 500 S 11th Ave Ste 400, Pocatello, ID 83201 |
| Enumerated | June 10, 2025 |
| Last updated | June 10, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker primary | 104100000X | 14225907-3502 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.