PEBBLE CREEK COUNSELING CENTER (NPI# 1407248222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407248222 |
| Entity Type | Organization |
| Organization Name | PEBBLE CREEK COUNSELING CENTER |
| Practice Address |
494 E 2400 N Ste B Tooele UT 84074 |
| Practice Telephone | 4352490321 |
| Practice Fax Number | 4352490360 |
| Mailing Telephone | 4352490321 |
| Mailing Fax Number | 4352490360 |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2015-03-03 |
| Authorized Official Name | MRS. MICHELLE MAIN (OWNER) |
| Authorized Official Telephone | 4352490321 |
| Authorized Official Credential | ACMHC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
327705-6009 | UT | Behavioral Health & Social Service Providers |
| Street Address |
494 E 2400 N STE B |
| City | TOOELE |
| State | UT |
| Zip Code | 84074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689233397 | Leah Elizabeth Harper I | Behavior Technician | 39 Millpond Stansbury Park, Tooele, UT 84074 | 2019-06-07 |
| 1245710789 | Tanna Marie Shelley | Community Health Worker | 27 So Main St, Tooele, UT 84074 | 2018-08-15 |
| 1528548062 | Barbara T Cederlof | Community Health Worker | 27 South Main St., Tooele, UT 84074 | 2018-08-15 |
| 1235615600 | Ashley Christine Wilson | Case Manager/Care Coordinator | 27 South Main, Tooele, UT 84074 | 2018-07-18 |
| 1174016976 | Makenzie Green | Case Manager/Care Coordinator | 27 S Main, Tooele, UT 84074 | 2018-06-07 |
| 1386151835 | Monica Lee | Physical Therapist | 6727 Ut-36 #300, Stansbury Park, UT 84074 | 2018-01-05 |
| 1871976183 | Pagnani Physical Therapy | Physical Therapist | 6727 North State Hwy 36, Suite 300, Stansbury Park, UT 84074 | 2015-07-06 |
| 1528496221 | Emily Carlson | Case Manager/Care Coordinator | 220 North Millpond Rd, Suite 100, Stansbury Park, UT 84074 | 2013-10-16 |
| 1710327218 | Angela Michelle Demoss | Nurse Practitioner | 682 Country Club, Stansbury Park, UT 84074 | 2013-06-28 |
| 1760826184 | Headache Relief Specialists LLC | Chiropractor | 1244 No Main, Suite 100, Tooele, UT 84074 | 2013-04-29 |
| Find all providers in zip 84074 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023537420 | Healing Heart Center for Meaningful Change LLC | Counselor | 300 S Main St Ste 2, Tooele, UT 84074-2784 | 2017-09-18 |
| 1205807542 | Linba Ann Beerymoreno | Counselor | Valley Mental Health/tooele Unit, 100 S 1000 W, Tooele, UT 84074 | 2006-01-26 |
| 1063070647 | Gerald Baird | Counselor | 50 N Main St, Tooele, UT 84074-2139 | 2019-05-30 |
| 1548745979 | Mitchell K Harris | Counselor | 50 N Main St, Tooele, UT 84074-2139 | 2018-10-02 |
| 1063995165 | Miriam Eileen Buell | Counselor | 50 N Main St, Tooele, UT 84074-2139 | 2018-09-13 |
| 1083966568 | Rita Josephine Butler | Counselor | 50 N Main St, Tooele, UT 84074-2139 | 2012-10-09 |
| 1932466687 | Adriane Neilson Warr | Counselor | 100 S 1000 W, Tooele, UT 84074-4010 | 2012-04-19 |
| 1457629750 | Michelle Main | Counselor | 494 East 2400 North, Tooele, UT 84074 | 2011-12-01 |
| 1023316577 | Michelle Elizabeth Kinder | Counselor | 100 S 1000 W, Tooele, UT 84074-4010 | 2011-03-08 |
| 1467759514 | George Alva Blackburn | Counselor | 134 W 1180 N, Tooele, UT 84074-1483 | 2011-02-24 |
| Find all providers in TOOELE | ||||
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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.