| Brookside Family Counseling Associates | |
|
1220 N Main St Ste 11 Springville UT 84663-4016 | |
| (801) 400-5034 | |
| (801) 373-4451 |
| Full Name | Brookside Family Counseling Associates |
|---|---|
| Speciality | Counselor |
| Location | 1220 N Main St Ste 11, Springville, Utah |
| Authorized Official Name and Position | Brent R. Hall (DIRECTOR) |
| Authorized Official Contact | 8014005034 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookside Family Counseling Associates 1220 N Main St Ste 11 Springville UT 84663-4016 Ph: (801) 400-5034 | Brookside Family Counseling Associates 1220 N Main St Ste 11 Springville UT 84663-4016 Ph: (801) 400-5034 |
| NPI Number | 1760104798 |
|---|---|
| Provider Enumeration Date | 09/15/2022 |
| Last Update Date | 05/30/2023 |
| Certification Date | 05/30/2023 |
| Medicare PECOS PAC ID | 9133588262 |
|---|---|
| Medicare Enrollment ID | O20230706003696 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760104798 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Secondary |
| Provider Name | Jennifer Ann Karr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417272170 PECOS PAC ID: 4789956632 Enrollment ID: I20170828001694 |
| Provider Name | Thomas A Rayner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194008979 PECOS PAC ID: 0941533574 Enrollment ID: I20220808003003 |
| Provider Name | Brent Hall |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1386840213 PECOS PAC ID: 1951760081 Enrollment ID: I20240405001388 |
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