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

Kelly Dawn Brose, LCSW

Individual provider Clinical Social Worker · NPI 1962811224

Kelly Dawn Brose, LCSW is a Clinical Social Worker in Provo, Utah. Qualified in 2016, 10 years ago. Practices with State of Utah, a 31-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
10
Licensed in
UT
In the registry since
2014
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

1300 E Center St
Provo, UT 84606
Phone: (801) 344-4400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 750 N Freedom Blvd, Provo, UT 84601-1677 — (801) 373-4760

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 9806442-3501 (UT)

Record details

NPI number1962811224
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedAugust 11, 2014
Last updated in NPPESJuly 11, 2019

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice State Of Utah — 31 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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