Christyn Gerber, ACMHC
Individual provider Active NPI Mental Health Counselor · Loa, UT
NPI 1629551007 · NPPES record last updated Jul 18, 2019
Key facts
- NPI
- 1629551007
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 11336680-6009 (UT)
- Practice address
- 520 N Aspen Rd
Loa, UT 84747 - Phone
- (866) 436-4458
- NPI assigned
- Sep 11, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11336680-6009 | UT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Volunteers of America | Past | Accepting new patients | |
| Juniper Canyon Recovery Center for Women, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Mental Health Counselor | 101YM0800X | 11336680-6009 | UT | Yes |
Addresses
Primary practice location
520 N Aspen Rd
Loa, UT 84747
Mailing address
520 N Aspen Rd
Loa, UT 84747
Phone (866) 436-4458
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548367881 | Medicaid | UT |
Other providers in Loa, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.