Brookside Wellness Center PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

BROOKSIDE WELLNESS CENTER PLLC

Practice address

4688 S Wallace Dr Unit G
Saint George, UT 84790-1863

Phone

(435) 429-1042

NPI assigned

Oct 14, 2025

Organization subpart

No

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

Authorized official

Name

Colby Gannon Backman, CMHCNPI 1063880839

Title

Program Director

Phone

(435) 429-1042

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Colby Gannon Backman, CMHC

  • Mental Health Counselor
  • St George, UT
  • NPI 1063880839
  NPD Authorized official

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

{
    "created_epoch": "1760400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1164398392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4688 S WALLACE DR UNIT G",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847901863",
            "telephone_number": "435-429-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4688 S WALLACE DR UNIT G",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847901863",
            "telephone_number": "435-429-1042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSIDE WELLNESS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-14",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "BACKMAN",
        "authorized_official_first_name": "COLBY",
        "authorized_official_middle_name": "GANNON",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "435-429-1042",
        "authorized_official_credential": "CMHC"
    },
    "taxonomies": [
        {
            "code": "101200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Drama Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Brianne Brook, DPT
• Daren Brooks, D.O.
• Kedrah Nicole Brooks
• Kelsey Marie Brooks, NP
• Kathryn Brooksby
• Brookstone Foundation
• Brookstone Medical Center
• Amy Engle Brotherson, LCSW
• Lawrence Brotherton
• Kevin Brough, MFT-I

• 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 Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.