Behavioral Health Services | |
3225 W Gordon Ave Layton UT 84041-6508 | |
(801) 773-7177 | |
(801) 498-7562 |
Full Name | Behavioral Health Services |
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Speciality | Psychologist - Clinical |
Location | 3225 W Gordon Ave, Layton, Utah |
Authorized Official Name and Position | Thomas Fairbank (PRES/OWNER) |
Authorized Official Contact | 8017737177 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Behavioral Health Services 1767 N 2525 E Layton UT 84040 Ph: (801) 773-7177 | Behavioral Health Services 3225 W Gordon Ave Layton UT 84041-6508 Ph: (801) 773-7177 |
NPI Number | 1144204926 |
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Provider Enumeration Date | 12/05/2005 |
Last Update Date | 07/14/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144204926 | NPI | - | NPPES |
000055010 | Other | UT | MEDICARE ID-PIN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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