Carlton Mangum, SSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6496349-6004 Issued in UT

Practice address

474 W 200 N
Suite 200
St. George, UT 84770-4505

Phone

(435) 634-5600

Fax

(435) 986-8700

NPI assigned

May 2, 2007

Last updated

Aug 5, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southwest CenterGroup PAC ID 0941246086, 18 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southwest Center

  • Multi-Specialty Clinic/Center
  • St George, UT
  • NPI 1922053586
  Medicare reassignment Care Compare group NPD
• Southwest Center

  dba Southwest Behavioral Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St George, UT
  • NPI 1285688515
  NPD
• Southwest Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • St George, UT
  • NPI 1548212640
  NPD

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1194947051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 W 200 N",
            "address_2": "SUITE 300",
            "city": "ST. GEORGE",
            "state": "UT",
            "postal_code": "847704505",
            "telephone_number": "435-634-5600",
            "fax_number": "435-986-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 W 200 N",
            "address_2": "SUITE 200",
            "city": "ST. GEORGE",
            "state": "UT",
            "postal_code": "847704505",
            "telephone_number": "435-634-5600",
            "fax_number": "435-986-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGUM",
        "first_name": "CARLTON",
        "credential": "SSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "6496349-6004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SBHC STAFF CODE",
            "identifier": "MANGUC",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "6496349-3503",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claire Maloy
• Jayson Malufau, DO
• Emily Maness
• Brooke Mangis, BEHAVIOR TECHNICIAN
• Levi Mangone
• Kaleb Mangum
• Ty Dallas Mangum, PA
• Veisinia Shirley Mann
• Kara Manning
• Kymri Manning

• 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 5, 2020; 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.