NPIMap

Organization Active NPI

Bear River District Health Dept

Doing business as Bear River Health Dept Behavioral Health

  • Addiction (Substance Use Disorder) Counselor
  • Logan, UT
National Provider Identifier
1205046711
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
BEAR RIVER DISTRICT HEALTH DEPT
Doing business as
Bear River Health Dept Behavioral Health
Practice address
655 E 1300 N
Logan, UT 84341
Phone
(435) 792-6500
Fax
(435) 792-6600
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Authorized official

Name
Mindy C Morehead
Title
Insurance Credentialing/Billing Spe
Phone
(435) 695-2077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

655 E 1300 N
Logan, UT 84341

Mailing address

655 E 1300 N
Logan, UT 84341
Phone (435) 792-6500

Other names 2

  • Bear River Health Dept Behavioral Health Doing business as
  • Bear River District Health Dept Substance Abuse Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070912000436 UT Part B Supplier - Clinic/Group Practice 3274633441 Receives reassigned benefits from 7 practitioners
Practice locations: Brigham City, UT; Logan, UT; Tremonton, UT

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Bear River District Health Dept5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

655 E 1300 N
Logan, UT 84341
Phone (435) 792-6491

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656028800000",
    "number": "1205046711",
    "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": "84341",
            "telephone_number": "435-792-6500",
            "fax_number": "435-792-6600"
        },
        {
            "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": "84341",
            "telephone_number": "435-792-6500",
            "fax_number": "435-792-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAR RIVER DISTRICT HEALTH DEPT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A",
        "authorized_official_last_name": "MOREHEAD",
        "authorized_official_first_name": "MINDY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "INSURANCE CREDENTIALING/BILLING SPE",
        "authorized_official_telephone_number": "435-695-2077"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bear River Health Dept Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bear River District Health Dept Substance Abuse",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jun 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.