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MR. BRAD KELSTROM LCSW
NPI 1396085486
Social Worker - Clinical in Logan, UT

Active since February 26, 2013Opted out of Medicare · through Sep 23, 2026
40 W CACHE VALLEY BLVD STE 10A, LOGAN, UT 84341(435) 787-2272 Get Directions Write a Review

NPPES record last updated: February 26, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Brad Kelstrom Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. BRAD KELSTROM LCSW (NPI 1396085486) is an individual clinical provider in Logan, Utah, licensed in Utah (7731529-3501) and active in the NPI registry since February 2013. He has opted out of Medicare through September 23, 2026.

NPPES Registry Identity

NPI1396085486
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. BRAD KELSTROMCredential: LCSW
Location Address40 W CACHE VALLEY BLVD STE 10ALogan, UT 84341-8450
Mailing Address40 W Cache Valley Blvd Ste 10aLogan, UT 84341-8450 · (435) 787-2272
Phone(435) 787-2272
Sole ProprietorNo
Enumeration DateFebruary 26, 2013
✔ NPI 1396085486 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in UT · 7731529-3501
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
40 W CACHE VALLEY BLVD STE 10A, Logan, UT 84341
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mr. Brad Kelstrom Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 23, 2020 through September 23, 2026.

Opt-Out Effective DateSeptember 23, 2020
Opt-Out In Effect ThroughSeptember 23, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BEHAVIORAL MENTAL HEALTH SERVICES, PC
Community/Behavioral Health
40 W CACHE VALLEY BLVD STE 10A
LOGAN, UT 84341
Cache County (435) 787-2272
JACOB GARRETT STACY LCSW, CSAT
Social Worker (Clinical)
40 W CACHE VALLEY BLVD STE 10A
LOGAN, UT 84341
Cache County (435) 787-2272

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brad Kelstrom's NPI number?

The NPI number for Brad Kelstrom is 1396085486. It was assigned to this individual provider in the NPPES registry on February 26, 2013.

Where is Brad Kelstrom located?

Brad Kelstrom practices at 40 W Cache Valley Blvd Ste 10A, Logan, UT 84341. The listed phone number is (435) 787-2272.

What is Brad Kelstrom's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Brad Kelstrom enrolled in Medicare?

No. Brad Kelstrom has opted out of Medicare through September 23, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Brad Kelstrom was last updated on February 26, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.