Pine Forest Counseling, PLLC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

9133425-2501 Issued in UT

Legal business name

PINE FOREST COUNSELING, PLLC

Practice address

1031 S Bluff St
Saint George, UT 84770-5206

Phone

(435) 319-0995

NPI assigned

Mar 27, 2015

Organization subpart

No

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

Authorized official

Name

Dylan Matsumori, PH.D.

Title

Psychologist

Phone

(435) 319-0995

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1356735237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 S BLUFF ST",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847705206",
            "telephone_number": "435-319-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 S BLUFF ST",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847705206",
            "telephone_number": "435-319-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE FOREST COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-27",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "MATSUMORI",
        "authorized_official_first_name": "DYLAN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "435-319-0995",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "UT",
            "license": "9133425-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counseling Psychologist in Saint George, UT
• Providers in Saint George, UT by specialty
• Counseling Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; 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.