Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jeffrey Breckenridge, CSW

Individual provider Clinical Social Worker · NPI 1649895954

Jeffrey Breckenridge, CSW is a Clinical Social Worker in Provo, Utah. Qualified in 2021, 5 years ago. Licensed in Idaho.

Years since qualifying
5
Licensed in
ID
In the registry since
2020

Practice location Address checks out

750 N Freedom Blvd
Provo, UT 84601-1677
Phone: (476) 080-1373
Fax: (801) 373-0639
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 8911450 (ID)

Record details

NPI number1649895954
Entity typeIndividual (Type 1)
GenderMale
Credentials CSW
Sole proprietorNo
NPI enumeratedJune 11, 2020
Last updated in NPPESMarch 20, 2026
Certification dateMarch 20, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated

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