PINNACLE ADDICTION AVE. & MENTAL HEALTH THERAPY (NPI# 1790306652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790306652 |
| Entity Type | Organization |
| Organization Name | PINNACLE ADDICTION AVE. & MENTAL HEALTH THERAPY |
| Practice Address |
3507 N University Ave Provo UT 84604-4478 |
| Mailing Address |
5108 W Eagle Hill Cir West Jordan UT 84081-3989 |
| Practice Telephone | 8018428062 |
| Practice Fax Number | 8013056006 |
| Mailing Telephone | 8018428062 |
| Enumeration Date | 2020-05-01 |
| Last Update Date | 2020-05-01 |
| Authorized Official Name | STACEY PERKO (OWNER) |
| Authorized Official Telephone | 8018428062 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Pinnacle Addiction Ave. & Mental Health Therapy | Doing Business As Name - Organization |
| Street Address |
3507 N UNIVERSITY AVE |
| City | PROVO |
| State | UT |
| Zip Code | 84604-4478 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265509269 | A Michelle Jones | Social Worker | 3507 N University Ave, Suite 350, Provo, UT 84604 | 2006-11-29 |
| 1972976082 | Max Ah Quin | Counselor | 3507 N University Ave, Suite 350, Provo, UT 84604-4478 | 2015-11-11 |
| 1811360936 | Max Ah Quin, LLC | Counselor | 3507 N University Ave, Building 6, Suite 350, Provo, UT 84604-4478 | 2015-11-11 |
| 1710398532 | Garret Roundy | Marriage & Family Therapist | 3507 N University Ave, #350, Provo, UT 84604-4478 | 2014-05-14 |
| 1417299827 | Northern Utah Center for Couples and Families, Pllc | Clinic/Center | 3507 N University Ave, Ste 350, Provo, UT 84604-4478 | 2013-03-23 |
| 1346386133 | Utah Valley Spinal Health LLC | Chiropractor | 3507 N University Ave, Ste 175, Provo, UT 84604-4478 | 2007-01-29 |
| 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 | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245792167 | Adrienne Lowden Dejager | Counselor | 314 S 1350 E, Provo, UT 84606-5318 | 2019-04-01 |
| 1699255315 | Michele Mcconkie Erekson | Counselor | 2545 N Canyon Rd Ste 112, Provo, UT 84604-5972 | 2018-08-21 |
| 1861980385 | Cory Bushman | Counselor | 455 N University Ave Ste 210, Provo, UT 84601-2868 | 2018-04-30 |
| 1013425594 | Tamara S Hill | Counselor | 3325 N University Ave Ste 275, Provo, UT 84604-7415 | 2018-01-18 |
| 1992150478 | Tristin Roney | Counselor | 1942 N 3100 W, Provo, UT 84601-5941 | 2016-05-03 |
| 1659760411 | Affinity Guidance Services, Inc | Counselor | 1971 N State St, Provo, UT 84604-1012 | 2015-01-16 |
| 1326460445 | Daniel Solen | Counselor | 2230 N University Pkwy Ste 11d, Provo, UT 84604-1583 | 2014-01-08 |
| 1235550526 | Richard James Bryan | Counselor | 567 N 2620 W, Provo, UT 84601-1187 | 2014-01-03 |
| 1508287947 | Ann Weight | Counselor | 4455 Wimbledon Dr, Provo, UT 84604-5394 | 2014-01-03 |
| 1508118456 | Linda Marie Taylor | Counselor | 719 N 1890 W Ste 38b, Provo, UT 84601-1333 | 2012-10-02 |
| 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.