Todd Pay

Individual provider Active NPI Counselor · Moroni, UT

NPI 1134628613 · NPPES record last updated Feb 9, 2018

Key facts

NPI
1134628613
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
Practice address
2860 East 19500 North
Moroni, UT 84646
Phone
(435) 262-1217
NPI assigned
Feb 9, 2018
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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 participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Hills Residential Treatment Past Accepting new patients
Lighthouse Ranch Corporation Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X UT Yes

Addresses

Primary practice location

2860 East 19500 North
Moroni, UT 84646

Mailing address

PO Box 461
Moroni, UT 84646-0461
Phone (435) 445-5200

Other identifiers

IdentifierTypeStateIssuer
1235458555MedicaidUT

Other providers in Moroni, UT

All providers in Moroni, UT · Counselor in Utah

Sources for this page

Verify at the official NPI Registry.