Four Corners Community Behavioral Health, Inc.
Organization Active NPI Community/Behavioral Health Agency · Price, UT
NPI 1487715330 · NPPES record last updated Aug 19, 2021
Key facts
- NPI
- 1487715330
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 11967 (UT)
- Legal business name
- FOUR CORNERS COMMUNITY BEHAVIORAL HEALTH, INC.
- Practice address
- 690 E Main St
Price, UT 84501-3166 - Phone
- (435) 637-7200
- Fax
- (435) 637-2377
- NPI assigned
- Dec 13, 2006
- Organization subpart
- No
Authorized official
- Name
- Melissa Huntington, CMHC
- Title
- Executive Director
- Phone
- (435) 613-2179
Other NPIs with the same Medicare PAC ID 1
Practitioners 194
-
Andrea D. Barney, APRN
-
Kelland Jay Brewer, CSW
-
Cheri Engberson, CSW
-
Michele Marie Huff, CSW MSW
-
Jeannee Hunt, PAC
-
Aja Elizabeth Lyman, MSW
-
Alison Marrelli, LCSW
-
Tiffany Brook Noyes, DNP, APRN, FNP-BC
-
William Blake Paul, M.A., L.M.F.T.
-
Andrew Rice, DNP, APRN
-
Zoe Atalie Robbins, NURSE PRACTITIONER
-
Meranda Saccomano, CSW
-
Lakecia Wilkinson, PA-C
-
Karen Dolan, LCSW
-
Kourtney Atwood, APRN
-
Michael Roy Lowry, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040220000304 | UT | Part B Supplier - Clinic/Group Practice | 2769377415 |
Receives reassigned benefits from 35 practitioners Practice locations: Castle Dale, UT; Moab, UT; Price, UT |
National Provider Directory
Locations
198 E Center St
Moab, UT 84532
Phone (435) 259-2432
105 W 100 N
Price, UT 84501
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 11967 | UT | Yes |
Addresses
Primary practice location
690 E Main St
Price, UT 84501-3166
Mailing address
PO Box 867
Price, UT 84501-0867
Phone (435) 637-7200
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Credible | Health Information Exchange (HIE) |
Other providers in Price, UT
- Ashley Fisher
- Sara Flannery
- Vance B. Fonnesbeck
- Michaela Fossat
- Four Corners Community Behavioral Health Inc
- Four Corners Community Behavioral Health, Inc.
- Kelli Fowles
- Mark A Frazier
- Rachel Ashley Freeman
- Alaena Fryer
All providers in Price, UT · Community/Behavioral Health Agency in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.