Provider Demographics
NPI:1851905939
Name:SOMERS, BRENDA (MSW, CSW)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:SOMERS
Suffix:
Gender:F
Credentials:MSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84404-5071
Mailing Address - Country:US
Mailing Address - Phone:801-393-7228
Mailing Address - Fax:
Practice Address - Street 1:564 CROSS ST
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-5071
Practice Address - Country:US
Practice Address - Phone:801-393-7228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2023-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5060873-3502101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health