GERALD LOUIS COSTLEY (NPI# 1164910089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164910089 |
| Entity Type | Individual |
| Full Name | GERALD LOUIS COSTLEY |
| Credential | LCSW |
| Practice Address |
339 E 3900 S Ste 155 Salt Lake City UT 84107-1978 |
| Practice Telephone | 8013470370 |
| Practice Fax Number | 8012613701 |
| Mailing Telephone | 8013470370 |
| Mailing Fax Number | 8012613701 |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2019-12-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | 128158-3501 | UT | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
128158-3501 | UT | Behavioral Health & Social Service Providers |
| Street Address |
339 E 3900 S STE 155 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84107-1978 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801407929 | Carol Elaine Lawrencecostley | Counselor | 339 E 3900 S Ste 155, Salt Lake City, UT 84107-1978 | 2020-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750262 | Nathan Haslam | Counselor | 636 E Roosevelt Ave, Salt Lake City, UT 84105-2121 | 2020-11-06 |
| 1962003541 | Allison Lee | Counselor | 565 S Post St, Salt Lake City, UT 84104-1346 | 2020-11-02 |
| 1699374439 | Heidemarie Lex | Counselor | 3125 E Kennedy Dr Apt 605, Salt Lake City, UT 84108-2156 | 2020-10-22 |
| 1477166759 | Utah Infertility Resource Center | Counselor | 1565 E 3300 S, Salt Lake City, UT 84106-3370 | 2020-08-26 |
| 1689292658 | Truu Management | Counselor | 1554 S State St, Salt Lake City, UT 84115-1632 | 2020-07-07 |
| 1275169823 | Ashley White | Counselor | 1190 S 300 E, Salt Lake City, UT 84111-4636 | 2020-03-16 |
| 1184257107 | Richard Gregg Buxton | Counselor | 739 S 300 W Unit 113, Salt Lake City, UT 84101-2617 | 2020-02-18 |
| 1609416254 | Rmc Counseling | Counselor | 155 E 900 S Ste 111213, Salt Lake City, UT 84111-4229 | 2020-01-12 |
| 1114563681 | Caroline Graham | Counselor | 131 E 700 S, Salt Lake City, UT 84111-3805 | 2019-11-20 |
| 1629622303 | Healing Feathers LLC | Counselor | 1174 E Graystone Way Ste 10, Salt Lake City, UT 84106-2671 | 2019-07-30 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84107 |
Please comment or provide details below to improve the information on GERALD LOUIS COSTLEY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.