DR. BRENT BLAISDELL (NPI# 1528461241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528461241 |
| Entity Type | Individual |
| Full Name | DR. BRENT BLAISDELL |
| Credential | PH.D. |
| Practice Address |
4403 Harrison Blvd Suite A-700 Ogden UT 84403-3271 |
| Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
| Practice Telephone | 8013875300 |
| Mailing Telephone | 8013875300 |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2015-02-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 273961-3902 | UT | Behavioral Health & Social Service Providers |
| Street Address |
4403 HARRISON BLVD SUITE A-700 |
| City | OGDEN |
| State | UT |
| Zip Code | 84403-3271 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518962794 | Fred George Seale Iv | Obstetrics & Gynecology | 4403 Harrison Blvd, Ste 4650, Ogden, UT 84403-3271 | 2005-06-15 |
| 1720502859 | Derek Smith | Physician Assistant | 4403 Harrison Blvd, Ogden, UT 84403-3271 | 2017-07-31 |
| 1245766393 | Jacob Saunders | Student in an Organized Health Care Education/Training Program | 4403 Harrison Blvd, Suite A-700, Ogden, UT 84403-3271 | 2017-05-11 |
| 1043746191 | Haleigh Emerson | Family Medicine | 4403 Harrison Blvd, Suite A700, Ogden, UT 84403-3271 | 2017-05-11 |
| 1457887507 | Madison Beatty | Student in an Organized Health Care Education/Training Program | 4403 Harrison Blvd, Suite A700, Ogden, UT 84403 | 2017-05-11 |
| 1669908711 | Spencer Ruben | Student in an Organized Health Care Education/Training Program | 4403 Harrison Blvd, Suite A700, Ogden, UT 84403-3271 | 2017-05-11 |
| 1376083147 | Linda Maria Jones | Nurse Practitioner | 4403 Harrison Blvd, Suite 3490, Ogden, UT 84403 | 2017-02-27 |
| 1114376431 | Jonas Legrand Peterson | Family Medicine | 4403 Harrison Blvd, Suite A-700, Ogden, UT 84403-3271 | 2016-06-07 |
| 1649629965 | Derek Paul Wille | Family Medicine | 4403 Harrison Blvd, Suite A-700, Ogden, UT 84403-3271 | 2016-06-07 |
| 1467838086 | Brandy Millward | Social Worker | 4403 Harrison Blvd, Suite 3630, Ogden, UT 84403-3271 | 2015-08-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235744632 | Megan Louise Larkins | Specialist/Technologist | 4000 Brinker Ave. The Apartments., Apartment 15, Ogden, UT 84403 | 2020-09-11 |
| 1154959062 | Joshua Clifford Hansen | Student in an Organized Health Care Education/Training Program | 4403 Harrison Boulevard, Ste A700, Ogden, UT 84403 | 2020-03-28 |
| 1346895935 | Positional Release Therapy Institute LLC | Specialist/Technologist | 1702 E. 5600 S., Ogden, UT 84403 | 2019-08-09 |
| 1841842077 | Braken Wooden | Chiropractor | 1893 Skyline Dr., Suite 204, South Ogden, UT 84403 | 2019-07-09 |
| 1023670569 | Wasatch Advanced Dental Care LLC | Dentist | 3590 Harrison Blvd Suite #1, Ogden, UT 84403 | 2019-07-05 |
| 1194237636 | Marci Niemeyer | Physician Assistant | 5929 Fashion Point Dr Ste 101, South Ogden, UT 84403 | 2017-10-24 |
| 1578081949 | Stephanie Jensen | Specialist/Technologist | 1473 36th Street, Ogden, UT 84403 | 2017-09-06 |
| 1891213385 | Forrest Sutherland | Specialist/Technologist | 1075 E 41st St., Ogden, UT 84403 | 2017-09-05 |
| 1184159022 | Nicole Lee Van Tassell | In Home Supportive Care | 1496 East 5600 South, Unit 6, Ogden, UT 84403 | 2017-04-28 |
| 1265889166 | Modern Dental Professionals Ut, PC | Dentist | 5974 S. Fashion Pointe Drive, Suite 210, South Ogden, UT 84403 | 2016-05-20 |
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| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356806392 | Colby Pomeroy | Marriage & Family Therapist | 972 Chambers St Ste 7, Ogden, UT 84403-4873 | 2019-02-04 |
| 1942748496 | Barrett Wilson | Marriage & Family Therapist | 1716 Binford St, Ogden, UT 84401-3036 | 2017-02-04 |
| 1902237779 | Michael Albright | Marriage & Family Therapist | 3535 Lincoln Ave, Ogden, UT 84401-4026 | 2013-12-04 |
| 1568899227 | Alisa Roberts | Marriage & Family Therapist | 1181 Christmas Box Lane, Ogden, UT 84404 | 2013-09-26 |
| 1942554910 | Pamela None Clark | Marriage & Family Therapist | 3440 Harrison Blvd., Suite 100, Ogden, UT 84403 | 2012-10-30 |
| 1295034072 | Ian Feinauer | Marriage & Family Therapist | 4463 Forest Green Dr, Ogden, UT 84403-3125 | 2011-03-20 |
| 1235443078 | Aaron Joseph Jeffrey | Marriage & Family Therapist | 3885 W Campus Dr, Ogden, UT 84408-5136 | 2010-08-04 |
| 1306162169 | Karly Rebecca Mcguire | Marriage & Family Therapist | 1140 36th Street Suite 202, Ogden, UT 84403 | 2010-04-19 |
| 1285811448 | Mark S. Adams | Marriage & Family Therapist | 6174 S 2375 E, Ogden, UT 84403-5330 | 2008-01-29 |
| 1841416468 | Melinda C Barker | Marriage & Family Therapist | 3500 Harrison Blvd Ste 101, Ogden, UT 84403-2038 | 2007-04-18 |
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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.