Provider Demographics
NPI:1194030924
Name:ROUTSON, BRANDY LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:LYNN
Last Name:ROUTSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 S STATE ST STE 250
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84015-1116
Mailing Address - Country:US
Mailing Address - Phone:801-855-7999
Mailing Address - Fax:801-855-7999
Practice Address - Street 1:129 S STATE ST STE 250
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015-1116
Practice Address - Country:US
Practice Address - Phone:801-855-7999
Practice Address - Fax:801-855-7999
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9109673-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical