SHASTA GALYON (NPI# 1750998084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750998084 |
| Entity Type | Individual |
| Full Name | SHASTA GALYON |
| Credential | PEER SUPPORT |
| Practice Address |
440 S 500 E Salt Lake City UT 84102-2705 |
| Practice Telephone | 8013598862 |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2020-09-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | UT | Other Service Providers |
| Street Address |
440 S 500 E |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84102-2705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912205824 | Jessica B. Jeffs | Counselor | 440 S 500 E, Salt Lake City, UT 84102 | 2011-03-02 |
| 1538772280 | Theron Ulysses Williams | Case Manager/Care Coordinator | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-08-24 |
| 1316556806 | Sheanna Cronnelly | Case Manager/Care Coordinator | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-07-30 |
| 1700401767 | Jordan Clark Esteban | Social Worker | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-06-15 |
| 1548881097 | Daysha Alayne Clukey | Licensed Practical Nurse | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-05-06 |
| 1780216093 | David Scott Cummins | Social Worker | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-02-05 |
| 1720619893 | John Ritter Pendergrass | Case Manager/Care Coordinator | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-01-28 |
| 1881238608 | Alvilda Olivia Pacheco | Counselor | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2019-11-05 |
| 1881237121 | Elizabeth Crawford | Marriage & Family Therapist | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2019-10-18 |
| 1063067346 | Samuel Harry Van Rensburg | Nurse Practitioner | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2019-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942818604 | Wendy Vazquez | Behavior Technician | 515 S 700 E Suit 2a, Salt Lake City, UT 84102 | 2020-07-20 |
| 1407481245 | Odyssey House Inc | Family Medicine | 743 E 300 S, Salt Lake City, UT 84102 | 2020-03-11 |
| 1093359960 | Hayle Mayer | Behavior Technician | 515 S 700 E Salt Lake City, Suite 2a, Salt Lake, UT 84102 | 2019-11-04 |
| 1326680869 | Ronald Mcdonald House of The Intermountain Area | Meals | 935 E. South Temple, Salt Lake City, UT 84102 | 2019-10-16 |
| 1508419581 | Claire Pemberton | Behavior Technician | 327 E 1300 S, Apt 2, Salt Lake City, UT 84102 | 2019-07-19 |
| 1558923144 | Olivia Anne Hardwick | Social Worker | Transitions At Slrmc, 86 S. 1100 E. Suite 404, Salt Lake City, UT 84102 | 2019-07-03 |
| 1649741802 | Colten Vancampen | Behavior Technician | 515 S 700 E #2a, Salt Lake City, UT 84102 | 2018-12-16 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1104311661 | Malorey Kooyman | Behavior Technician | 515 700 East, Suite 2a, Salt Lake City, UT 84102 | 2018-06-27 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| Find all providers in zip 84102 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043819600 | Devin J Morrison | Peer Specialist | 230 W 200 S Unit 142, Salt Lake City, UT 84110-6006 | 2020-10-23 |
| 1518579077 | Henry Matthews | Peer Specialist | 474 N Grant St, Salt Lake City, UT 84116-2726 | 2020-08-17 |
| 1134780042 | Michael James Olsen | Peer Specialist | 344 E 100 S Ste 301300, Salt Lake City, UT 84111-1700 | 2019-06-23 |
| 1659836393 | Brittney Emi Vaovasa | Peer Specialist | 252 W Brooklyn Ave, Salt Lake City, UT 84101-3024 | 2019-02-06 |
| 1306348263 | Kurt Kyle Landenberger | Peer Specialist | 2200 S State St Fl 2, Salt Lake City, UT 84115-2724 | 2018-03-06 |
| 1922609320 | Teri Christensen | Peer Specialist | 230 W 200 S # 142, Salt Lake City, UT 84101-1337 | 2020-11-03 |
| 1821698713 | Kim Katherine Stephens | Peer Specialist | 230 W 200 S # 142, Salt Lake City, UT 84101-1337 | 2020-10-29 |
| 1225638364 | Anna Elizabeth Dees | Peer Specialist | 230 W 200 S Ste 142, Salt Lake City, UT 84101-1337 | 2020-10-28 |
| 1124628268 | Amber Wilkins I | Peer Specialist | 230 W 200 S # 142, Salt Lake City, UT 84101-1337 | 2020-10-28 |
| 1811596885 | Kaylie A Larsen | Peer Specialist | 230 W 200 S # 142, Salt Lake City, UT 84101-1337 | 2020-10-21 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84102 |
Please comment or provide details below to improve the information on SHASTA GALYON.
| 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.