| Four Corners Community Behavioral Health, Inc. | |
|
690 E Main St Price UT 84501-3166 | |
| (435) 637-7200 | |
| (435) 637-2377 |
| Full Name | Four Corners Community Behavioral Health, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 690 E Main St, Price, Utah |
| Authorized Official Name and Position | Melissa Huntington (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4356132179 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Corners Community Behavioral Health, Inc. Po Box 867 Price UT 84501-0867 Ph: (435) 637-7200 | Four Corners Community Behavioral Health, Inc. 690 E Main St Price UT 84501-3166 Ph: (435) 637-7200 |
| NPI Number | 1487715330 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 08/19/2021 |
| Certification Date | 08/19/2021 |
| Medicare PECOS PAC ID | 2769377415 |
|---|---|
| Medicare Enrollment ID | O20040220000304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487715330 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 11967 (Utah) | Primary |
| Provider Name | John S Montgomery |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023073483 PECOS PAC ID: 8426035676 Enrollment ID: I20040706000682 |
| Provider Name | Michael R Lowry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932116662 PECOS PAC ID: 4688697493 Enrollment ID: I20060107000018 |
| Provider Name | Ann L Prazza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023075801 PECOS PAC ID: 6901816792 Enrollment ID: I20060424000390 |
| Provider Name | Darlene L Petersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376744433 PECOS PAC ID: 1557413903 Enrollment ID: I20090715000402 |
| Provider Name | Andrea D Barney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366676587 PECOS PAC ID: 8123211380 Enrollment ID: I20101020000327 |
| Provider Name | Karen M Dolan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639134000 PECOS PAC ID: 7214116318 Enrollment ID: I20110121000144 |
| Provider Name | David L Moulton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558332353 PECOS PAC ID: 4486654092 Enrollment ID: I20120814000422 |
| Provider Name | Zoe A Robbins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134321508 PECOS PAC ID: 6507090800 Enrollment ID: I20130927000285 |
| Provider Name | Tiffany B Noyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225576267 PECOS PAC ID: 1052683240 Enrollment ID: I20170823001880 |
| Provider Name | Christine A Wibby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932574092 PECOS PAC ID: 8325341258 Enrollment ID: I20180125000916 |
| Provider Name | Lauren Prest |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881012235 PECOS PAC ID: 3971804147 Enrollment ID: I20180419002491 |
| Provider Name | Nathan A Sauter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952645236 PECOS PAC ID: 6002154853 Enrollment ID: I20190220002937 |
| Provider Name | Michele M Huff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518455518 PECOS PAC ID: 3577998145 Enrollment ID: I20200109000907 |
| Provider Name | Aja E Lyman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952824740 PECOS PAC ID: 0840625000 Enrollment ID: I20200115002899 |
| Provider Name | Meranda Eileen Saccomano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285903260 PECOS PAC ID: 6507292737 Enrollment ID: I20200207000472 |
| Provider Name | Alicia Cooper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124573746 PECOS PAC ID: 4880021583 Enrollment ID: I20200322000255 |
| Provider Name | Kelland Brewer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750869863 PECOS PAC ID: 7911323480 Enrollment ID: I20200813003393 |
| Provider Name | Michelle L Saggboy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114537149 PECOS PAC ID: 8921492034 Enrollment ID: I20220304001811 |
| Provider Name | Joseph Woodard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801133905 PECOS PAC ID: 7113313222 Enrollment ID: I20220329002013 |
| Provider Name | Larua Dotson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699345264 PECOS PAC ID: 1557734852 Enrollment ID: I20230308000555 |
| Provider Name | Stacey Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073809489 PECOS PAC ID: 6103291919 Enrollment ID: I20230410001439 |
Eastern Utah Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 945 W Hospital Dr Ste 7, Price, UT 84501 Phone: 435-637-6734 Fax: 435-637-6422 | |
Castle Country Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 375 S Carbon Ave, Suite B-11, Price, UT 84501 Phone: 435-637-5032 | |
Kara Heugly Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 70 W Main St, Price, UT 84501 Phone: 435-637-0171 | |
Four Corners Community Behavioral Health Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 77 S 600 E, Price, UT 84501 Phone: 435-637-7289 | |
Gravetti Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 53 S 700 E, Price, UT 84501 Phone: 435-610-1896 | |
Alpha Center Social Work Counseling & Consultation Services, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 375 S Carbon Ave, Suite 132, Price, UT 84501 Phone: 435-749-9944 |