Individual provider Active NPI

Joseph Sean Maynard, APC

  • Counselor
  • Brigham City, UT
National Provider Identifier
1861784084
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
7744640-6009 Issued in UT
Practice address
58 S 950 W
Brigham City, UT 84302-4424
Phone
(435) 538-5061
NPI assigned
May 5, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 7744640-6009 UT Primary

Addresses

Primary practice location

58 S 950 W
Brigham City, UT 84302-4424

Mailing address

PO Box 526
Brigham City, UT 84302-0526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240430003351 UT Practitioner - Mental Health Counselor 8729428354 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7744640-6009UTMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bear River Mental Health Services Inc CurrentSince Mar 25, 2024 Accepting new patients
Triumph Youth Services Past Accepting new patients

Locations

663 W Hospital Rd
Brigham City, UT 84302
Phone (435) 734-9449

90 E 200 N
Logan, UT 84321
Phone (435) 752-0750

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304553600000",
    "number": "1861784084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 526",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843020526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 S 950 W",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843024424",
            "telephone_number": "435-538-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "JOSEPH",
        "middle_name": "SEAN",
        "name_prefix": "Mr.",
        "credential": "APC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-05",
        "last_updated": "2011-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "UT",
            "license": "7744640-6009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brigham City, UT

Sources for this page

Verify at the official NPI Registry.