IndividualActive
Brent Tycksen, LCSW
NPI 1962856930 · Clinical Social Worker · Provo, UT
Provider details
- NPI number
- 1962856930
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- No
- License
- 10535183-3501 (UT)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5600 North 250 West
Provo, UT 84604
Phone: (801) 226-4600
Approximate (ZIP-level) locationGet directions
Mailing address
173 E 10000 S
Salem, UT 84653-9253
Additional practice locations (1)
- 750 N Freedom BlvdProvo, UT 84601-1677Phone: (801) 373-4760Fax: (801) 373-0639
Registry dates
- Enumerated
- 2016-04-15
- Last updated
- 2023-10-23
- Certified
- 2023-10-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.