JON LEROY PERTAB (NPI# 1215239348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215239348 |
| Entity Type | Individual |
| Full Name | JON LEROY PERTAB |
| Credential | PH.D. |
| Practice Address |
5171 South Cottonwood St Suite 810 Neurosciences Institute Murray UT 84107 |
| Practice Telephone | 8015079800 |
| Practice Fax Number | 8015079800 |
| Mailing Telephone | 8015079800 |
| Mailing Fax Number | 8015079800 |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2013-05-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | 7759498-2501 | UT | Behavioral Health & Social Service Providers |
| Y | 103T00000X | Psychologist | 7759498-2501 | UT | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
7759498-2501 | UT | Behavioral Health & Social Service Providers |
| N | 103TH0004X |
Psychologist Specialization: Health |
7759498-2501 | UT | Behavioral Health & Social Service Providers |
| Street Address |
5171 SOUTH COTTONWOOD ST SUITE 810 NEUROSCIENCES INSTITUTE, |
| City | MURRAY |
| State | UT |
| Zip Code | 84107 |
| 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 | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942828520 | Ihc Health Services Inc | Psychologist | 5373 S Green St Ste 400, Murray, UT 84123-4740 | 2020-07-09 |
| 1386138584 | Sean Peter Simons | Psychologist | 3201 Alexander Hall, Murray, KY 42071-3377 | 2018-06-20 |
| 1144640343 | Tabitha Devine | Psychologist | 1653 Ryan Ave, Murray, KY 42071-1768 | 2014-04-26 |
| 1245452861 | Pamela R. Awana | Psychologist | 111 E. 5600 So., Suite 310, Murray, UT 84107 | 2007-05-03 |
| 1255496931 | Aharon David Shulimson | Psychologist | 5248 Pinemont Dr, Suite C-110, Murray, UT 84123-2702 | 2006-12-24 |
| 1649830936 | Scott York | Psychologist | 1051 N 16th St Ste B, Murray, KY 42071-8511 | 2019-06-18 |
| 1316459621 | Monica Dee Christy | Psychologist | 5383 S 900 E Ste 290, Murray, UT 84117-7268 | 2017-10-26 |
| 1447650338 | Julia Hood | Psychologist | 5965 S 900 E, Murray, UT 84121-1720 | 2014-08-27 |
| 1134424641 | Nathanael W Ridge | Psychologist | 5770 S 250 E, #290, Murray, UT 84107-8100 | 2011-01-13 |
| 1669647616 | Craig Freeman Spiel | Psychologist | 181 E Medical Tower Dr, Murray, UT 84107-4872 | 2008-04-29 |
| Find all providers in MURRAY | ||||
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| 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.