Kolob Therapeutic Services

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1397173501 Issued in UT

Legal business name

KOLOB THERAPEUTIC SERVICES

Practice address

437 S Bluff St Ste 202
St George, UT 84770-3555

Phone

(435) 674-4464

NPI assigned

Nov 28, 2011

Organization subpart

No

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

Authorized official

Name

Martha Ham, L.C.S.W.

Title

Director

Phone

(435) 674-4464

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1275800823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 S BLUFF ST STE 202",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703555",
            "telephone_number": "435-674-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 S BLUFF ST STE 202",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703555",
            "telephone_number": "435-674-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOLOB THERAPEUTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "HAM",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "435-674-4464",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "1397173501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Koford, ACMHC
• Austin Robert Kogan
• Lisa Kogan, FNP
• Shawn Kolar, PHARMD.
• Brian Bennett Koldyke, MSN, FNP-C
• Kenza Komara
• Jayce Komiya
• Yocoli Konan
• Rebekah Korn
• Breanna Dana Korth, CSW

• Clinical Social Worker in St George, UT
• Providers in St George, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.