Grant Pemberton, CMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

8856945-6004 Issued in UT

Practice address

321 N Mall Dr
St George, UT 84790-7302

Phone

(435) 862-8612

NPI assigned

Jun 13, 2019

Last updated

Jun 13, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Connected Care Clinic

  • Professional Counselor
  • St George, UT
  • NPI 1629884234
  NPD Authorized official

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1619537503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 LONDON LN",
            "city": "SANTA CLARA",
            "state": "UT",
            "postal_code": "847655643",
            "telephone_number": "435-705-3678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N MALL DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907302",
            "telephone_number": "435-862-8612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMBERTON",
        "first_name": "GRANT",
        "name_prefix": "Mr.",
        "credential": "CMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "8856945-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "grantopemberton@gmail.com",
            "affiliation": "N",
            "address_1": "3910 London Ln",
            "city": "Santa Clara",
            "state": "UT",
            "country_code": "US",
            "postal_code": "847655643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Susan Jean Peck, RN
• Dayana S. Pelayo
• Christian Andrew Pelletier
• Alyssa Peluffo, DPT
• Heather Pelzer
• Toni Pemberton, FNP-BC
• Pender Athletic Brands, Inc. (Celtic Touch)
• Mary Kathryn Pender, LMT
• Shanna Pender
• Gus Curtis Pendleton, M.D.

• Mental Health Counselor in St George, UT
• Providers in St George, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.