UTAH LAKES NEUROSCIENCE MENTAL HEALTH CENTER PLLC (NPI# 1609404813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609404813 |
| Entity Type | Organization |
| Organization Name | UTAH LAKES NEUROSCIENCE MENTAL HEALTH CENTER PLLC |
| Practice Address |
3549 N University Ave Ste 200 Provo UT 84604-4417 |
| Mailing Address |
223 W Cougar Blvd # 704 Provo UT 84604-2546 |
| Practice Telephone | 3852652484 |
| Practice Fax Number | 8778945104 |
| Mailing Telephone | 3852652484 |
| Mailing Fax Number | 8778945104 |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2020-04-02 |
| Authorized Official Name | LILIANA RONEY (OWNER) |
| Authorized Official Telephone | 3852652484 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | LCSW LICENSE | 11486773-3501 | 01 |
| Street Address |
3549 N UNIVERSITY AVE STE 200 |
| City | PROVO |
| State | UT |
| Zip Code | 84604-4417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881730604 | Jennifer Anne Morrill | Psychologist | 3549 N University Ave Ste 200, Provo, UT 84604 | 2007-01-29 |
| 1740896653 | Danielle Town | Marriage & Family Therapist | 3549 N University Ave Ste 200, Provo, UT 84604-4417 | 2020-09-17 |
| 1467074179 | Daniel Brice Kay | Psychologist | 3549 N University Ave Ste 200, Provo, UT 84604-4417 | 2020-05-15 |
| 1669855425 | Brooklyn Elise Cook | Counselor | 3549 N University Ave Ste 200, Provo, UT 84604-4417 | 2015-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154943868 | Joy Bouchard | Social Worker | 1933 N 1120 W, Provo, UT 84604-1044 | 2020-05-15 |
| 1275181596 | Karmen Tuivai | Social Worker | 1507 N University Ave Ste 150, Provo, UT 84604-2657 | 2019-08-29 |
| 1144876798 | Marilyn Taylor Morgan | Social Worker | 1765 N 1550 E, Provo, UT 84604-5710 | 2019-08-09 |
| 1700379369 | Building Beginnings Recovery | Social Worker | 286 S 600 E Ste A, Provo, UT 84606-4780 | 2018-06-08 |
| 1922555093 | Scott Parker | Social Worker | 63 N 300 E, Provo, UT 84606-3241 | 2016-09-07 |
| 1316348394 | Mary Reas | Social Worker | 225 S 300 E, Provo, UT 84606-4743 | 2014-09-10 |
| 1053721399 | Brigham Young | Social Worker | 1190 N 900 E Ste 204, Provo, UT 84604-3536 | 2014-05-07 |
| 1902221328 | Christine Lindsey | Social Worker | 2230 N University Pkwy Ste 7e, Provo, UT 84604-6701 | 2014-02-21 |
| 1447671896 | Cory Virgin | Social Worker | 558 N 2310 W, Provo, UT 84601-7253 | 2014-01-01 |
| 1912345877 | Kate Aryn Edwards | Social Worker | 161 W 400 S Apt 6, Provo, UT 84601-4519 | 2013-06-12 |
| Find all providers in PROVO | ||||
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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.