| Jacob Grant Brown, CMHC | |
|
1020 S Main St, Salt Lake City, UT 84101-3176 | |
| (888) 949-4864 | |
| Not Available |
| Full Name | Jacob Grant Brown |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 8 Years |
| Location | 1020 S Main St, 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 |
|---|---|---|---|
| 1962912501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LAC-16935 (Arizona) | Secondary |
| 101YP2500X | Counselor - Professional | 10540388-6004 (Utah) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Valley Mental Health Incorporated | 0042121196 | 62 |
| Entity Name | Valley Mental Health Incorporated |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275599797 PECOS PAC ID: 0042121196 Enrollment ID: O20031111000937 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob Grant Brown, CMHC 3725 W 4100 S Ste 201, West Valley City, UT 84120-6490 Ph: () - | Jacob Grant Brown, CMHC 1020 S Main St, Salt Lake City, UT 84101-3176 Ph: (888) 949-4864 |
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 |