NPIMap

Organization Active NPI

Springville Family Counseling Services

Doing business as Brookside Family Counseling

  • Mental Health Counselor
  • Springville, UT
National Provider Identifier
1760104798
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SPRINGVILLE FAMILY COUNSELING SERVICES
Doing business as
Brookside Family Counseling
Brookside Family Counseling Associates
Practice address
1220 N Main St Ste 11
Springville, UT 84663-4016
Phone
(801) 400-5034
Fax
(801) 373-4451
NPI assigned
Sep 15, 2022
Last updated
May 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Authorized official

Name
Mr. Brent R. Hall, LMFTNPI 1386840213
Title
Director
Phone
(801) 400-5034

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Counseling Psychologist 103TC1900X

Addresses

Primary practice location

1220 N Main St Ste 11
Springville, UT 84663-4016

Mailing address

1220 N Main St Ste 11
Springville, UT 84663-4016
Phone (801) 400-5034

Other practice location 1

105 N 500 W
Provo, UT 84601-2646
Phone (801) 400-5034

Other names 2

  • Brookside Family Counseling Doing business as
  • Brookside Family Counseling Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230706003696 UT Part B Supplier - Clinic/Group Practice 9133588262 Receives reassigned benefits from 6 practitioners
Practice locations: Provo, UT; Springville, UT

National Provider Directory

National Provider Directory

Locations

1220 N Main St
Ste 11
Springville, UT 84663
Phone (801) 361-0982

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685404800000",
    "number": "1760104798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 N MAIN ST STE 11",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846634016",
            "telephone_number": "801-400-5034",
            "fax_number": "801-373-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 N MAIN ST STE 11",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846634016",
            "telephone_number": "801-400-5034",
            "fax_number": "801-373-4451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 N 500 W",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846012646",
            "country_code": "US",
            "telephone_number": "801-400-5034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPRINGVILLE FAMILY COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-15",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "801-400-5034",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookside Family Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brookside Family Counseling Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brookside Family Counseling Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.