| Burton Fullmer, LPC | |
|
5689 S Redwood Rd, Suite 30, Salt Lake City, UT 84123-5447 | |
| (801) 268-1715 | |
| (801) 268-1783 |
| Full Name | Burton Fullmer |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 22 Years |
| Location | 5689 S Redwood Rd, Salt Lake City, Utah |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295087112 | NPI | - | NPPES |
| 3785956004 | Other | UT | PROFESSIONAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 3785956004 (Utah) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Smile Psychiatry And Behavioral | 4082138904 | 2 |
| Deborah A Christensen Phd And Associates, Inc | 6901891498 | 22 |
| Entity Name | Deborah A Christensen Phd & Associates, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891955936 PECOS PAC ID: 6901891498 Enrollment ID: O20040415000323 |
| Entity Name | Smile Psychiatry And Behavioral |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043970262 PECOS PAC ID: 4082138904 Enrollment ID: O20250411002021 |
| Mailing Address | Practice Location Address |
|---|---|
| Burton Fullmer, LPC 5689 S Redwood Rd, Suite 30, Salt Lake City, UT 84123-5447 Ph: (801) 268-1715 | Burton Fullmer, LPC 5689 S Redwood Rd, Suite 30, Salt Lake City, UT 84123-5447 Ph: (801) 268-1715 |
Douglas Ray Stafford, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 411 Grant St, Salt Lake City, UT 84116 Phone: 801-359-8862 | |
Mr. Siope Lee Kinikini, CHMC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5800 Highland Dr, Salt Lake City, UT 84121 Phone: 801-272-9980 Fax: 801-272-9976 | |
Jesenia Sanchez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 607 E 200 S, Salt Lake City, UT 84102 Phone: 801-363-0203 Fax: 801-359-3455 | |
Steven Alec Jensen, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5965 S 900 E, Salt Lake City, UT 84121 Phone: 801-263-7100 | |
Austin Giove, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5965 S 900 E, Salt Lake City, UT 84121 Phone: 801-263-7100 | |
Clarissa Weiss, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5965 S 900 E, Salt Lake City, UT 84121 Phone: 801-263-7100 | |
Katalina Takuvaka, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124 Phone: 888-949-4864 |