Individual provider Active NPI

David Brent Tate, PH.D.

  • Counseling Psychologist
  • St George, UT
National Provider Identifier
1093992711
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
289126-2501 Issued in UT
Practice address
321 N Mall Dr
Suite I-201
St George, UT 84790-7302
Phone
(435) 656-0506
Fax
(435) 272-4009
NPI assigned
Jan 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 289126-2501 UT Primary

Addresses

Primary practice location

321 N Mall Dr
Suite I-201
St George, UT 84790-7302

Mailing address

321 N Mall Dr
Suite I-201
St George, UT 84790-7302
Phone (435) 656-0506

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040421000246 UT Practitioner - Clinical Psychologist 9830184514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

321 N Mall Dr
Suite I201
St George, UT 84790-7323
Phone (435) 656-0506

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
David B Tate PHD LLC Counseling CurrentSince Nov 14, 2016 Accepting new patients
Center for Stress Reduction, Inc. Counseling PastSince Apr 20, 2004 Accepting new patients
Behavioral Health Services Past Accepting new patients

Locations

321 N Mall Dr
Ste I201
St George, UT 84790
Phone (435) 574-2995

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.

NPI Registry JSON

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1093992711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N MALL DR",
            "address_2": "SUITE I-201",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907302",
            "telephone_number": "435-656-0506",
            "fax_number": "435-272-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N MALL DR",
            "address_2": "SUITE I-201",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907302",
            "telephone_number": "435-656-0506",
            "fax_number": "435-272-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "DAVID",
        "middle_name": "BRENT",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-24",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "UT",
            "license": "289126-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.