Garry Richard Holbrook Sr., LCSW

Individual provider Active NPI Mental Health Counselor · Panguitch, UT

NPI 1013165802 · NPPES record last updated Jan 14, 2013

Key facts

NPI
1013165802
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
609 North Main
#3
Panguitch, UT 84759
Phone
(435) 676-3020
Fax
(435) 676-8832
NPI assigned
Sep 4, 2008
Sex
Male
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services Inc (3,948 clinicians)

Practice addresses (Care Compare)

525 N Main St
Ephraim, UT 84627-1155
Phone (435) 283-4076

Medicare participation

Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20130530000746 UT Practitioner - Clinical Social Worker 7113165275 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. Current
since Jun 14, 2015
Accepting new patients
Ihc Health Services Inc Current
since Jun 14, 2015
Accepting new patients

Locations

130 White Sage Ave
Delta, UT 84624
Phone (435) 864-2708

525 N Main St
Ephraim, UT 84627
Phone (435) 283-4075

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1100 S Medical Dr
Mt Pleasant, UT 84647
Phone (435) 462-2441

1000 N Main St
Ste A
Richfield, UT 84701
Phone (435) 893-0580

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X UT Yes

Addresses

Primary practice location

609 North Main
#3
Panguitch, UT 84759

Mailing address

PO Box 63
Panguitch, UT 84759-0063
Phone (435) 676-3020

Other providers in Panguitch, UT

All providers in Panguitch, UT · Mental Health Counselor in Utah

Sources for this page

Verify at the official NPI Registry.