| Shepherds Staff Christian Counseling Center Inc | |
|
404 E 4500 S Ste B22 Murray UT 84107-2776 | |
| (801) 268-1564 | |
| (801) 268-1565 |
| Full Name | Shepherds Staff Christian Counseling Center Inc |
|---|---|
| Speciality | Psychologist |
| Location | 404 E 4500 S Ste B22, Murray, Utah |
| Authorized Official Name and Position | Robert Frederick Pramann (BOARD MEMBER AND CLINICAL DIRECTOR) |
| Authorized Official Contact | 8012681564 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shepherds Staff Christian Counseling Center Inc 404 E 4500 S Ste B22 Murray UT 84107-2776 Ph: (801) 268-1564 | Shepherds Staff Christian Counseling Center Inc 404 E 4500 S Ste B22 Murray UT 84107-2776 Ph: (801) 268-1564 |
| NPI Number | 1558395525 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 10/31/2024 |
| Certification Date | 10/31/2024 |
| Medicare PECOS PAC ID | 7911988316 |
|---|---|
| Medicare Enrollment ID | O20040531000003 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558395525 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Robert Frederick Pramann |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487622908 PECOS PAC ID: 4385672450 Enrollment ID: I20111212000222 |
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