| Samuel Pond | |
|
2027 N 200 E North Logan UT 84341-5505 | |
| (435) 764-6312 | |
| Not Available |
| Full Name | Samuel Pond |
|---|---|
| Speciality | Clinic/Center |
| Location | 2027 N 200 E, North Logan, Utah |
| Authorized Official Name and Position | Samuel Pond (OWNER) |
| Authorized Official Contact | 4357646312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel Pond 2027 N 200 E North Logan UT 84341-5505 Ph: (435) 764-6312 | Samuel Pond 2027 N 200 E North Logan UT 84341-5505 Ph: (435) 764-6312 |
| NPI Number | 1437885266 |
|---|---|
| Provider Enumeration Date | 07/25/2022 |
| Last Update Date | 11/17/2022 |
| Certification Date | 11/17/2022 |
| Medicare PECOS PAC ID | 5890163091 |
|---|---|
| Medicare Enrollment ID | O20221118002212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437885266 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Samuel Harris Pond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285166108 PECOS PAC ID: 6709254907 Enrollment ID: I20221118002343 |
Robert S. Cook, Ph.d., Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1750 Research Park Way, Suite 104, North Logan, UT 84341 Phone: 435-753-0272 Fax: 435-753-2252 | |
Rex Alan Spendlove, Ms, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1635 N 200 E, North Logan, UT 84341 Phone: 435-213-3687 Fax: 435-753-7654 | |
Golden Steps Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2600 N Main St # 200, North Logan, UT 84341 Phone: 435-774-6533 | |
Dana Jackson, Lcsw, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 186 E 1800 N Ste 1, North Logan, UT 84341 Phone: 435-213-3026 | |
Curtis R. Canning, Md, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1750 Research Park Way, Suite 104, North Logan, UT 84341 Phone: 435-753-0272 Fax: 435-753-2252 |