Provider Demographics
NPI:1225991771
Name:BROWN, JESSICA LEIGH (LCSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEIGH
Last Name:BROWN
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 1:940 E 480 S
Mailing Address - Street 2:
Mailing Address - City:RIVER HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84321-5854
Mailing Address - Country:US
Mailing Address - Phone:435-374-8552
Mailing Address - Fax:
Practice Address - Street 1:940 E 480 S
Practice Address - Street 2:
Practice Address - City:RIVER HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84321-5854
Practice Address - Country:US
Practice Address - Phone:435-374-8552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-03
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7701443-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical