NPI 1689753774 · live from the CMS NPI Registry
Brock B Alder, LCSW
Counselor, Addiction (Substance Use Disorder) in Logan, UT. National Provider Identifier 1689753774, active.
NPI record
| NPI | 1689753774 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Addiction (Substance Use Disorder) 101YA0400X |
| Practice location | 655 E 1300 N, Logan, UT 84341 |
| Practice phone | 435-792-6500 |
| Enumerated | November 2, 2006 |
| Last updated | March 7, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical | 1041C0700X | LCSW-875 (ID) |
| Counselor, Addiction (Substance Use Disorder) primary | 101YA0400X | 139698-3501 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.