NPIMap

Organization Active NPI

Family & Relationship Wellness Therapy

Doing business as Justin Gordon, LMFT

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St George, UT
National Provider Identifier
1235656729
Registry record updated Aug 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
8017789-3902 Issued in UT
Legal business name
FAMILY & RELATIONSHIP WELLNESS THERAPY
Doing business as
Justin Gordon, LMFT
Practice address
1031 S Bluff St
St George, UT 84770-5206
Phone
(435) 215-3184
Fax
(435) 634-8899
NPI assigned
Aug 24, 2017
Last updated
Aug 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2017

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

Authorized official

Name
Justin Gordon, LMFTNPI 1861766586
Title
Therpist/Owner
Phone
(435) 215-3184

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 8017789-3902 UT Primary

Addresses

Primary practice location

1031 S Bluff St
St George, UT 84770-5206

Mailing address

336 W 3162 S
Washington, UT 84780-8352
Phone (435) 215-3184

Other names 1

  • Justin Gordon, LMFT Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503532800000",
    "number": "1235656729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 W 3162 S",
            "city": "WASHINGTON",
            "state": "UT",
            "postal_code": "847808352",
            "telephone_number": "435-215-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 S BLUFF ST",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847705206",
            "telephone_number": "435-215-3184",
            "fax_number": "435-634-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY & RELATIONSHIP WELLNESS THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-24",
        "last_updated": "2017-08-24",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "THERPIST/OWNER",
        "authorized_official_telephone_number": "435-215-3184",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "UT",
            "license": "8017789-3902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Justin Gordon, LMFT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2017; 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.