| Sycamore Mental Health | |
|
111 E Forest St Ste H Brigham City UT 84302-2127 | |
| (801) 588-9538 | |
| Not Available |
| Full Name | Sycamore Mental Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 111 E Forest St Ste H, Brigham City, Utah |
| Authorized Official Name and Position | Joan C Rasmussen (OWNER) |
| Authorized Official Contact | 8015889538 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sycamore Mental Health 669 S Appaloosa Cir Willard UT 84340-9629 Ph: (801) 588-9538 | Sycamore Mental Health 111 E Forest St Ste H Brigham City UT 84302-2127 Ph: (801) 588-9538 |
| NPI Number | 1497525125 |
|---|---|
| Provider Enumeration Date | 01/03/2024 |
| Last Update Date | 01/03/2024 |
| Certification Date | 01/03/2024 |
| Medicare PECOS PAC ID | 2860834777 |
|---|---|
| Medicare Enrollment ID | O20240523002163 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497525125 | NPI | - | NPPES |
| 1982106852 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Joan C Rasmussen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982106852 PECOS PAC ID: 3274912647 Enrollment ID: I20240523002249 |
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