Takavar Ghane, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6782719-6004 Issued in UT

Practice address

1664 S Dixie Dr Ste E102
St George, UT 84770-7329

Phone

(435) 703-9647

Fax

(435) 703-6003

NPI assigned

Jul 26, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alberto Souza PLLCGroup PAC ID 1254766371, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Alberto Souza, PLLC

  dba Integrated Psych, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • St George, UT
  • NPI 1972141588
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1053864066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1664 S DIXIE DR STE E102",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847707329",
            "telephone_number": "435-703-9647",
            "fax_number": "435-703-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 S DIXIE DR STE E102",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847707329",
            "telephone_number": "435-703-9647",
            "fax_number": "435-703-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHANE",
        "first_name": "TAKAVAR",
        "name_prefix": "Mr.",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-26",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "6782719-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Miller Geranios, RN
• Olivia Gerbasi
• Trevor Michael Gerber, PA
• Sherrrie Gerry, CMHC
• Matthew C Gertsch, M.D.
• Christine Gibb, LMFT
• Cohen Gibb
• Reed Thomas Gibb, O.D.
• Cole A Gibbons, M.D.
• Debra Gibbons, L.M.F.T.

• Mental Health Counselor in St George, UT
• Providers in St George, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.