Ammon KC Fawson, LMFT – Marriage & Family Therapist

Key facts

NPI: 1013286129
Entity type: Individual (NPI type 1)
Primary specialty: Marriage & Family Therapist 106H00000X
License: 8375045-3902 (UT)
Practice address: 1045 8TH Ave NW
Byron, MN 55920-1590
Phone: (801) 603-9880
NPI assigned: Dec 19, 2011
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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.

Endeavor Clinic Marriage & Family Therapist · Byron, MN · NPI 1972995512

NPD MARRIAGE & FAMILY THERAPIST

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
8375045-3902	UT	MD	Marriage & Family Therapist

Practice roles

Organization	Specialty	Status	New patients
Endeavor Clinic	Marriage & Family Therapist	Current since May 12, 2024	Accepting new patients

Locations

2721 N 400 E
Ste 10
North Ogden, UT 84414

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Marriage & Family Therapist	106H00000X	8375045-3902	UT	Yes

Addresses

Primary practice location

1045 8TH Ave NW
Byron, MN 55920-1590

Mailing address

102 College Ave
Durham, NC 27713-6032
Phone (801) 648-9742

Other providers in Byron, MN

All providers in Byron, MN · Marriage & Family Therapist in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.