Raulon Van Tassell – Counselor in Thatcher, UT

Key facts

NPI: 1942503545
Entity type: Individual (NPI type 1)
Primary specialty: Counselor 101Y00000X
Practice address: 8606 N 11600 W
Thatcher, UT 84337-9103
Phone: (435) 854-7295
NPI assigned: Dec 21, 2010
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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.

Apex Youth Services Children's Substance Abuse Rehabilitation Facility · Thatcher, UT · NPI 1396169728

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Apex Youth Services		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Counselor	101Y00000X			Yes

Addresses

Primary practice location

8606 N 11600 W
Thatcher, UT 84337-9103

Mailing address

PO Box 526
Brigham City, UT 84302-0526
Phone (435) 538-5061

Other providers in Thatcher, UT

All providers in Thatcher, UT · Counselor in Utah

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2010. 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.

Verify at the official NPI Registry.