MR. GRANT PEMBERTON (NPI# 1619537503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619537503 |
| Entity Type | Individual |
| Full Name | MR. GRANT PEMBERTON |
| Credential | CMHC |
| Practice Address |
321 N Mall Dr St George UT 84790-7302 |
| Mailing Address |
3910 London Ln Santa Clara UT 84765-5643 |
| Practice Telephone | 4358628612 |
| Mailing Telephone | 4357053678 |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2019-06-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
8856945-6004 | UT | Behavioral Health & Social Service Providers |
| Street Address |
321 N MALL DR |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84790-7302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437258480 | Darren Boyd Earl | Dentist | 321 N Mall Dr, # F102, St George, UT 84790 | 2006-09-22 |
| 1467925883 | Saskia Ann Stallings | Counselor | 321 N Mall Dr, St George, UT 84790-7302 | 2019-01-08 |
| 1255815692 | Victoria Kate Graff | Social Worker | 321 N Mall Dr, E 102, St George, UT 84790-7302 | 2018-09-21 |
| 1407308737 | David B Tate Phd LLC | Psychologist | 321 N Mall Dr, Suite I-201, St George, UT 84790-7323 | 2016-11-03 |
| 1710436019 | Amy Michelle Tikalsky | Behavior Technician | 321 N Mall Dr, Suite E102, St George, UT 84790-7302 | 2016-09-27 |
| 1215320775 | Dental Center of St. George LLC | Health Maintenance Organization | 321 N Mall Dr, #p101, St George, UT 84790-7302 | 2015-03-09 |
| 1528476421 | David H Jones | Marriage & Family Therapist | 321 N Mall Dr, Vw-103, St George, UT 84790 | 2014-07-24 |
| 1427485101 | Cecilie Ott | Marriage & Family Therapist | 321 N Mall Dr, St George, UT 84790-7302 | 2013-09-26 |
| 1144566654 | Irvin Paul Dunsdon | Massage Therapist | 321 N Mall Dr, Bldg I #102, St George, UT 84790-7302 | 2013-01-02 |
| 1548534043 | Chad A Graff, Ph.d., LLC | Counselor | 321 N Mall Dr, Vw101, St George, UT 84790-7302 | 2012-03-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342713 | Katrina Poulsen | Student in an Organized Health Care Education/Training Program | 617 East Rriverside Dr, Ste 301, St. George, UT 84790 | 2020-10-08 |
| 1124643226 | Desert View Eyecare | Optometrist | 15 South River Road St. 150, St. George, UT 84790 | 2020-06-15 |
| 1366066417 | Benjamin Todd Lloyd | Dentist | 1683 E. Wolf Hole Dr, St. George, UT 84790 | 2020-06-04 |
| 1801434584 | Jennifer M Putnam | Marriage & Family Therapist | 321 North Mall Drive, Vw103, St. George, UT 84790 | 2019-12-12 |
| 1326683012 | Red Mountain Counseling and Education | Counselor | 321 No Mall Dr, Vw 103, St. George, UT 84790 | 2019-11-17 |
| 1295376002 | Karynne Kimberly Simpson | Behavior Technician | 280 N 1680 E U1, St. George, UT 84790 | 2019-10-02 |
| 1962053017 | Mikala Larsen | Nurse Practitioner | 1380 S Medical Center Dr., Saint George, UT 84790 | 2019-09-20 |
| 1326690678 | Joe Ballent | Student in an Organized Health Care Education/Training Program | 1526 S Medical Center Dr Ste 224a, St George, UT 84790 | 2019-07-16 |
| 1558923854 | David Pace | Optometrist | 749 South River Rd, St. George, UT 84790 | 2019-07-08 |
| 1639734924 | Mariah Ann Mertlich | Behavioral Analyst | 280 N 1680 E, U1, St. George, UT 84790 | 2019-05-02 |
| Find all providers in zip 84790 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104437623 | Counseling for Success Inc | Counselor | 166 N 300 W Ste 4, St George, UT 84770-2770 | 2020-08-10 |
| 1881215291 | Laura Helquist | Counselor | 321 N Mall Dr # 0-101, St George, UT 84790-7302 | 2020-04-27 |
| 1952861841 | Billie Jene Authement Acheson | Counselor | 620 S 400 E Ste 404, St George, UT 84770-7065 | 2019-03-25 |
| 1801352380 | Brayden Sloan | Counselor | 225 N Country Ln Unit 55, St George, UT 84770-8458 | 2019-02-20 |
| 1578095683 | Leigh Ann Stambaugh | Counselor | 1031 S Bluff St # 130, St George, UT 84770-5206 | 2017-03-28 |
| 1093252348 | Kathryn G Price Lcmhc LLC | Counselor | 292 S 1470 E, St George, UT 84790-1763 | 2017-01-25 |
| 1659825271 | Connie Hanson | Counselor | 230 N 1680 E Ste T2, St George, UT 84790-2573 | 2016-08-11 |
| 1063880839 | Colby Gannon Backman | Counselor | 301 N 200 E Ste 2c, St George, UT 84770-3040 | 2015-09-09 |
| 1306255435 | Tracy Davis | Counselor | 638 E 3470 S, St George, UT 84790-6246 | 2014-08-02 |
| 1053733949 | Erin Boorman | Counselor | 1240 E 100 S Ste 121, St George, UT 84790-3079 | 2014-01-10 |
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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.