| Vmh - A&d First Program | |
|
5965 S 900 E Suite 240 Salt Lake City UT 84121-1720 | |
| (801) 263-7225 | |
| (801) 263-7279 |
| Full Name | Vmh - A&d First Program |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5965 S 900 E, Salt Lake City, Utah |
| Authorized Official Name and Position | Debra Falvo (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8012637100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vmh - A&d First Program 5965 S 900 E Salt Lake City UT 84121-1720 Ph: (801) 263-7100 | Vmh - A&d First Program 5965 S 900 E Suite 240 Salt Lake City UT 84121-1720 Ph: (801) 263-7225 |
| NPI Number | 1275599797 |
|---|---|
| Provider Enumeration Date | 04/24/2006 |
| Last Update Date | 08/25/2011 |
| Medicare PECOS PAC ID | 0042121196 |
|---|---|
| Medicare Enrollment ID | O20031111000937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275599797 | NPI | - | NPPES |
| 2423 | Other | UT | PEHP |
| Provider Name | Gail C Hilton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033354857 PECOS PAC ID: 2961300876 Enrollment ID: I20031229000977 |
| Provider Name | Sharon R Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366421299 PECOS PAC ID: 0042208464 Enrollment ID: I20040504001381 |
| Provider Name | Linda K Lasley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174501019 PECOS PAC ID: 2567450505 Enrollment ID: I20040506000225 |
| Provider Name | Kendall G Lowe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558306506 PECOS PAC ID: 6608847678 Enrollment ID: I20040806001055 |
| Provider Name | Frances M Matuszewski |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1295955821 PECOS PAC ID: 9537115217 Enrollment ID: I20050324001331 |
| Provider Name | Elizabeth Albertsen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871575472 PECOS PAC ID: 2264470996 Enrollment ID: I20050421001439 |
| Provider Name | Mark L Martinez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508861964 PECOS PAC ID: 7911942909 Enrollment ID: I20050621000457 |
| Provider Name | Kent C Kravitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669557245 PECOS PAC ID: 0749382091 Enrollment ID: I20070216000570 |
| Provider Name | Victoria Jacobs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730217167 PECOS PAC ID: 3971607243 Enrollment ID: I20070326000299 |
| Provider Name | Robert K Strachan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497725055 PECOS PAC ID: 0941385520 Enrollment ID: I20080306000286 |
| Provider Name | William Asper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407835218 PECOS PAC ID: 1153408844 Enrollment ID: I20080404000505 |
| Provider Name | Jenise D Tingey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194946129 PECOS PAC ID: 1850441866 Enrollment ID: I20090613000022 |
| Provider Name | Benjamin Todd Thatcher |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841310950 PECOS PAC ID: 8820161847 Enrollment ID: I20090818000580 |
| Provider Name | John L Malouf |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104801620 PECOS PAC ID: 8426240037 Enrollment ID: I20101013001208 |
| Provider Name | Sarah L Debois |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285605584 PECOS PAC ID: 4789877671 Enrollment ID: I20101023000321 |
| Provider Name | Christopher D Cavin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114237807 PECOS PAC ID: 0244414068 Enrollment ID: I20110401000729 |
| Provider Name | James G Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336317650 PECOS PAC ID: 9436316627 Enrollment ID: I20120130000865 |
| Provider Name | Daniel D Furse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154659027 PECOS PAC ID: 0941467492 Enrollment ID: I20120210000475 |
| Provider Name | Clare D Eggett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568725760 PECOS PAC ID: 1153571070 Enrollment ID: I20121030000154 |
| Provider Name | Julie Rael |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104151232 PECOS PAC ID: 4385899194 Enrollment ID: I20130228000293 |
| Provider Name | Andrea W Beckstrom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336396928 PECOS PAC ID: 4587800628 Enrollment ID: I20130416000694 |
| Provider Name | Marcella B Wolf |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598772030 PECOS PAC ID: 8325932239 Enrollment ID: I20130806000323 |
| Provider Name | Bridget K Domeier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508111360 PECOS PAC ID: 0941444145 Enrollment ID: I20130909000738 |
| Provider Name | Julie Goodman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992095350 PECOS PAC ID: 2466682919 Enrollment ID: I20140228000435 |
| Provider Name | Jeanette Marie Ricci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114340650 PECOS PAC ID: 8022249366 Enrollment ID: I20140328002224 |
| Provider Name | Brett Pearce |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255620407 PECOS PAC ID: 1254555071 Enrollment ID: I20140618001467 |
| Provider Name | Laura Marie Bennett Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669898540 PECOS PAC ID: 8921224379 Enrollment ID: I20140722000332 |
| Provider Name | Alan R Chidester |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386938751 PECOS PAC ID: 7911129218 Enrollment ID: I20141120001129 |
| Provider Name | Susan Maureen Godwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346648946 PECOS PAC ID: 1850615014 Enrollment ID: I20150115002362 |
| Provider Name | Kathleen Mack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326211624 PECOS PAC ID: 1153498910 Enrollment ID: I20150129002213 |
| Provider Name | Rene Valles |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013015189 PECOS PAC ID: 0143534370 Enrollment ID: I20150731017239 |
| Provider Name | Debbie Sutherland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669440178 PECOS PAC ID: 3274849286 Enrollment ID: I20150904000772 |
| Provider Name | Jessica Hale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699745844 PECOS PAC ID: 2860702883 Enrollment ID: I20151103003075 |
| Provider Name | Jeri Melton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568803666 PECOS PAC ID: 5294045076 Enrollment ID: I20151106000496 |
| Provider Name | Lindsey Ann Macfarlane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205154978 PECOS PAC ID: 6709178692 Enrollment ID: I20160713002472 |
| Provider Name | Denise Brooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164781852 PECOS PAC ID: 2769774553 Enrollment ID: I20160715000051 |
| Provider Name | Tifani Holloway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497008379 PECOS PAC ID: 1355636556 Enrollment ID: I20160826002359 |
| Provider Name | Susan Toles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225209349 PECOS PAC ID: 8527353739 Enrollment ID: I20160826002408 |
| Provider Name | Jose Gutierrez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245684125 PECOS PAC ID: 2466740873 Enrollment ID: I20161017002805 |
| Provider Name | Jennifer Poulos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407153547 PECOS PAC ID: 9739469321 Enrollment ID: I20161219001158 |
| Provider Name | Julie Winn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093148405 PECOS PAC ID: 4981985231 Enrollment ID: I20161229000708 |
| Provider Name | Eva Losaline Tukuafu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255713582 PECOS PAC ID: 7214218221 Enrollment ID: I20170106000427 |
| Provider Name | Jonathan Voigt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396066221 PECOS PAC ID: 8527349257 Enrollment ID: I20170111001564 |
| Provider Name | Matt Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972901452 PECOS PAC ID: 4587946843 Enrollment ID: I20170120001549 |
| Provider Name | Kirsten Leah Novak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336175967 PECOS PAC ID: 0042523573 Enrollment ID: I20170728003289 |
| Provider Name | Andrea Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437670114 PECOS PAC ID: 0941573794 Enrollment ID: I20170830002070 |
| Provider Name | Jerry Ben Romero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902862881 PECOS PAC ID: 2264799279 Enrollment ID: I20171129003059 |
| Provider Name | Sarah Elaine Kaihau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497272025 PECOS PAC ID: 8325308414 Enrollment ID: I20180209002476 |
| Provider Name | Jeremy Ratliff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295255701 PECOS PAC ID: 3476816729 Enrollment ID: I20180418002935 |
| Provider Name | Kim Estella Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659772028 PECOS PAC ID: 3577888155 Enrollment ID: I20180612002661 |
| Provider Name | Matthew D Barrus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386071223 PECOS PAC ID: 0648529362 Enrollment ID: I20180814000900 |
| Provider Name | Timothy Champlin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760926901 PECOS PAC ID: 6305181108 Enrollment ID: I20181226001138 |
| Provider Name | Brennan Paite Howick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659666725 PECOS PAC ID: 3476899907 Enrollment ID: I20190103003228 |
| Provider Name | Karem Gisell Garza-solis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871841049 PECOS PAC ID: 8325384886 Enrollment ID: I20190104001004 |
| Provider Name | Justin Allen Northway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811464589 PECOS PAC ID: 1355680802 Enrollment ID: I20190228001938 |
| Provider Name | Stephanie Larsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164808788 PECOS PAC ID: 9335488600 Enrollment ID: I20190304001955 |
| Provider Name | Isaac Day Steele |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1386142586 PECOS PAC ID: 0941549935 Enrollment ID: I20190311000164 |
| Provider Name | Erin P Perez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336618891 PECOS PAC ID: 2365782935 Enrollment ID: I20190318001190 |
| Provider Name | Leslie Jeanette Curtis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598053407 PECOS PAC ID: 2567795941 Enrollment ID: I20190618001600 |
| Provider Name | Stephen Palmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194128256 PECOS PAC ID: 8628302627 Enrollment ID: I20190625002920 |
| Provider Name | Nicole Yolette Melling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083105506 PECOS PAC ID: 8426386525 Enrollment ID: I20190828000725 |
| Provider Name | Jannah Lee Faumuina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063884427 PECOS PAC ID: 5193054781 Enrollment ID: I20190906001791 |
| Provider Name | Christian Michael Judd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700121332 PECOS PAC ID: 2961834767 Enrollment ID: I20191116000479 |
| Provider Name | Ann Pennington Marsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770140790 PECOS PAC ID: 0941634612 Enrollment ID: I20200106001484 |
| Provider Name | Lisa Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619519469 PECOS PAC ID: 8224463559 Enrollment ID: I20200115000794 |
| Provider Name | Nicole Campolucci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265733414 PECOS PAC ID: 2567898372 Enrollment ID: I20200213002380 |
| Provider Name | Sanghee Kweon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720457427 PECOS PAC ID: 2860828647 Enrollment ID: I20200214002002 |
| Provider Name | Carrie Anne Naughton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659342129 PECOS PAC ID: 5890122832 Enrollment ID: I20200303002305 |
| Provider Name | Neva Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083837207 PECOS PAC ID: 5193899599 Enrollment ID: I20200303002756 |
| Provider Name | Tynesha Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720465362 PECOS PAC ID: 0749618502 Enrollment ID: I20200310002584 |
| Provider Name | Michael Hacking |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841764529 PECOS PAC ID: 1759711849 Enrollment ID: I20200413001799 |
| Provider Name | Dara Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558921429 PECOS PAC ID: 6608202205 Enrollment ID: I20200415001396 |
| Provider Name | Archana A Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659925915 PECOS PAC ID: 4981035144 Enrollment ID: I20200504002107 |
| Provider Name | Rachel Lott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164984175 PECOS PAC ID: 5698191666 Enrollment ID: I20200820003280 |
| Provider Name | Alisa Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952822645 PECOS PAC ID: 6406273283 Enrollment ID: I20200825001040 |
| Provider Name | Daniel Patrick Hart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043647035 PECOS PAC ID: 4385061514 Enrollment ID: I20200902000583 |
| Provider Name | Kimmy Kyung Kwong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710504253 PECOS PAC ID: 2567882293 Enrollment ID: I20201020000618 |
| Provider Name | Veronica Carranza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184199689 PECOS PAC ID: 9537571807 Enrollment ID: I20201209002946 |
| Provider Name | Marci L Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730472283 PECOS PAC ID: 8527470293 Enrollment ID: I20201222001954 |
| Provider Name | Matthew Michael Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437714292 PECOS PAC ID: 2961815022 Enrollment ID: I20210108001859 |
| Provider Name | Caron Lynn Gould |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629557251 PECOS PAC ID: 1557761228 Enrollment ID: I20210617000553 |
| Provider Name | Beth Janine Makar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124648894 PECOS PAC ID: 5395146807 Enrollment ID: I20210622001107 |
| Provider Name | Kady Newland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467940189 PECOS PAC ID: 8820486582 Enrollment ID: I20211028002683 |
| Provider Name | Jennifer Nybo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982293056 PECOS PAC ID: 7810388956 Enrollment ID: I20211227001115 |
| Provider Name | Jody Neeley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295327054 PECOS PAC ID: 3870985393 Enrollment ID: I20220113000890 |
| Provider Name | Jacob Michael Oaklyn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275139339 PECOS PAC ID: 6709278575 Enrollment ID: I20220128001014 |
| Provider Name | Theresa Margaret Furbish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679174908 PECOS PAC ID: 7517351422 Enrollment ID: I20220218000233 |
| Provider Name | Kristina Marya Friman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396984217 PECOS PAC ID: 4284783994 Enrollment ID: I20220321002090 |
| Provider Name | Abigail Elaine Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699338624 PECOS PAC ID: 9638556061 Enrollment ID: I20220524001544 |
| Provider Name | Laura Beth Hanson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154391365 PECOS PAC ID: 0244609196 Enrollment ID: I20221215001071 |
| Provider Name | Christopher Thomas Lange |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982976239 PECOS PAC ID: 4789056466 Enrollment ID: I20230206001749 |
| Provider Name | Corinne Bowen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043812753 PECOS PAC ID: 2264806595 Enrollment ID: I20230328000531 |
| Provider Name | Kali Aileen Novak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235796863 PECOS PAC ID: 3274907480 Enrollment ID: I20230329001148 |
| Provider Name | Emogene Elizabeth Hennick-dunn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326695990 PECOS PAC ID: 7517331721 Enrollment ID: I20230329001262 |
| Provider Name | Nicole Elizabeth Probst |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073096996 PECOS PAC ID: 6204200413 Enrollment ID: I20230329001596 |
| Provider Name | Alexandra Frances Fawcett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376160952 PECOS PAC ID: 7911371182 Enrollment ID: I20230330000909 |
| Provider Name | Kelsi Cook |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073906699 PECOS PAC ID: 8921465279 Enrollment ID: I20230601001960 |
| Provider Name | Lauren Bolte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558860544 PECOS PAC ID: 4789047176 Enrollment ID: I20230901000760 |
| Provider Name | Russell Allan Pryor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144528357 PECOS PAC ID: 3476901513 Enrollment ID: I20231129002866 |
| Provider Name | Lindsey Hulet Van Roo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225695877 PECOS PAC ID: 9537517693 Enrollment ID: I20231129003386 |
| Provider Name | Brittany Grove |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669971834 PECOS PAC ID: 2264881275 Enrollment ID: I20231214003500 |
| Provider Name | Cheryl Christy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891277521 PECOS PAC ID: 8325491400 Enrollment ID: I20240124004117 |
| Provider Name | Jamal Ahmed Barakat |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912983446 PECOS PAC ID: 4981057072 Enrollment ID: I20240124004467 |
| Provider Name | Ashley A Hanson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275927444 PECOS PAC ID: 7315390440 Enrollment ID: I20240125001051 |
| Provider Name | Rebecca Kapp Dow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801410113 PECOS PAC ID: 8820441967 Enrollment ID: I20240125001233 |
| Provider Name | Bruce K. Fordham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326267311 PECOS PAC ID: 6204289374 Enrollment ID: I20240125002276 |
| Provider Name | Jeanna Cunningham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619445608 PECOS PAC ID: 4385097450 Enrollment ID: I20240125002310 |
| Provider Name | Tori Eyre |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225789142 PECOS PAC ID: 5991158917 Enrollment ID: I20240125004429 |
| Provider Name | Jesse R Hardman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932643632 PECOS PAC ID: 2860845898 Enrollment ID: I20240125004684 |
| Provider Name | David C Haymond |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841633955 PECOS PAC ID: 5092168955 Enrollment ID: I20240126001420 |
| Provider Name | Christopher Thomas Lange |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982976239 PECOS PAC ID: 4789056466 Enrollment ID: I20240126002460 |
| Provider Name | Angelique Rosemary Larrabee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699009647 PECOS PAC ID: 1052764966 Enrollment ID: I20240126003349 |
| Provider Name | Kimberli Elizabeth Smaellie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285048843 PECOS PAC ID: 0941653869 Enrollment ID: I20240126003457 |
| Provider Name | Kristine Louise Lublin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942280557 PECOS PAC ID: 2062865991 Enrollment ID: I20240126004177 |
| Provider Name | Michelle Moyes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639492036 PECOS PAC ID: 6103279955 Enrollment ID: I20240128000199 |
| Provider Name | Michael S Thompson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1164733994 PECOS PAC ID: 0345693008 Enrollment ID: I20240129004155 |
| Provider Name | Jacob Grant Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962912501 PECOS PAC ID: 0648623314 Enrollment ID: I20240129004422 |
| Provider Name | Alexandria Walje |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326751082 PECOS PAC ID: 2466805130 Enrollment ID: I20240129004430 |
| Provider Name | David Raymond Walker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134419948 PECOS PAC ID: 5799138467 Enrollment ID: I20240129004583 |
| Provider Name | Edward Allen Seiler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740627637 PECOS PAC ID: 6204289911 Enrollment ID: I20240130001039 |
| Provider Name | Tyler Mcdonald |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144749755 PECOS PAC ID: 8729431382 Enrollment ID: I20240130003201 |
| Provider Name | Christina Kathryn Harden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073006219 PECOS PAC ID: 8224442926 Enrollment ID: I20240131004367 |
| Provider Name | Esperanza Hobby |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1306236286 PECOS PAC ID: 2466895750 Enrollment ID: I20240202002637 |
| Provider Name | June Lee Hernandez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588952816 PECOS PAC ID: 5890138119 Enrollment ID: I20240202003587 |
| Provider Name | Lanette Rose Best |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508117458 PECOS PAC ID: 1557705852 Enrollment ID: I20240214002765 |
| Provider Name | Corylyn Lisa Ybarra |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013207562 PECOS PAC ID: 5597109827 Enrollment ID: I20240214004212 |
| Provider Name | Jessica Palmer-thurston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902228968 PECOS PAC ID: 2860830163 Enrollment ID: I20240405000831 |
| Provider Name | Aaron J Higley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255579819 PECOS PAC ID: 2769822436 Enrollment ID: I20240429000599 |
Shrinkster, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 860 E 4500 S Ste 302, Salt Lake City, UT 84107 Phone: 801-685-9600 Fax: 801-268-3777 | |
Burton Counseling Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1433 S 1100 E, Salt Lake City, UT 84105 Phone: 801-581-0422 | |
Sacred Circle Health Care Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 660 S 200 E Ste 250, Salt Lake City, UT 84111 Phone: 801-359-2256 Fax: 801-364-4392 | |
Palliative Medicine Associates Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 888 E 3900 S, Suite B, Salt Lake City, UT 84107 Phone: 801-747-0330 | |
Journey Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1343 S Main St Ste B, Salt Lake City, UT 84115 Phone: 801-803-8105 | |
Blossom Aba Therapy Ut Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2795 E Cottonwood Pkwy, Salt Lake City, UT 84121 Phone: 732-730-7505 | |
Michael S Buxton Phd Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1399 S 700 E Ste 11, Salt Lake City, UT 84105 Phone: 801-318-1900 |