Active NPI
Mark Perkins
- Addiction (Substance Use Disorder) Counselor
- Logan, UT
National Provider Identifier
1154729721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 309942-6008
- Practice address
- 655 E 1300 N
Logan, UT 84341-2570 - Phone
- (435) 792-6491
- Fax
- (435) 792-6608
- NPI assigned
- Dec 15, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 309942-6008 | UT | Primary |
Addresses
Primary practice location
655 E 1300 N
Logan, UT 84341-2570
Mailing address
655 E 1300 N
Logan, UT 84341-2570
Phone (435) 792-6491
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 309942-6008 | UT | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418601600000",
"number": "1154729721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "655 E 1300 N",
"city": "LOGAN",
"state": "UT",
"postal_code": "843412570",
"telephone_number": "435-792-6491",
"fax_number": "435-792-6608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "655 E 1300 N",
"city": "LOGAN",
"state": "UT",
"postal_code": "843412570",
"telephone_number": "435-792-6491",
"fax_number": "435-792-6608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERKINS",
"first_name": "MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-15",
"last_updated": "2014-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "UT",
"license": "309942-6008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.