Individual provider Active NPI

Julie Ann Bleak, LMFT

  • Marriage & Family Therapist
  • St George, UT
National Provider Identifier
1912770413
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
640 E 700 S Ste 205B
St George, UT 84770-5773
Phone
(435) 688-1111
NPI assigned
Nov 6, 2023
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X NU Primary

Addresses

Primary practice location

640 E 700 S Ste 205B
St George, UT 84770-5773

Mailing address

1173 S 250 W Ste 208
St George, UT 84770-6747
Phone (435) 688-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Couples & Families Marriage & Family Therapist CurrentSince Nov 12, 2023 Accepting new patients
Center for Couples & Families Marriage & Family Therapist CurrentSince Nov 12, 2023 Accepting new patients

Locations

1173 S 250 W
Ste 208
St George, UT 84770
Phone (435) 632-6900

1490 E Foremaster Dr
Ste 340
St George, UT 84790
Phone (435) 216-9290

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1912770413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1173 S 250 W STE 208",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847706747",
            "telephone_number": "435-688-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E 700 S STE 205B",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847705773",
            "telephone_number": "435-688-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEAK",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.