| South Point Counseling Services, Llc | |
|
1206 W South Jordan Pkwy Ste D South Jordan UT 84095-5519 | |
| (801) 302-3801 | |
| (801) 302-7248 |
| Full Name | South Point Counseling Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1206 W South Jordan Pkwy Ste D, South Jordan, Utah |
| Authorized Official Name and Position | Roselene Sallum Dalanhese (CLINICAL DIRECTOR/OWNER) |
| Authorized Official Contact | 8014037345 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Point Counseling Services, Llc 1206 W South Jordan Pkwy Ste D South Jordan UT 84095-5519 Ph: (801) 302-3801 | South Point Counseling Services, Llc 1206 W South Jordan Pkwy Ste D South Jordan UT 84095-5519 Ph: (801) 302-3801 |
| NPI Number | 1265709844 |
|---|---|
| Provider Enumeration Date | 11/25/2011 |
| Last Update Date | 04/01/2021 |
| Certification Date | 04/01/2021 |
| Medicare PECOS PAC ID | 0749430650 |
|---|---|
| Medicare Enrollment ID | O20121030000092 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265709844 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 5222307-3501 (Utah) | Primary |
| Provider Name | Susi C Dalanhese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477764843 PECOS PAC ID: 3072683796 Enrollment ID: I20080605000800 |
| Provider Name | Roselene S Dalanhese |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821187246 PECOS PAC ID: 4183819220 Enrollment ID: I20101115000415 |
| Provider Name | William R Kastner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982906616 PECOS PAC ID: 8527201342 Enrollment ID: I20130827000401 |
| Provider Name | Kristina Talbert |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558605360 PECOS PAC ID: 8820355316 Enrollment ID: I20171208002577 |
| Provider Name | Tracie Lynn Hoffman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831337104 PECOS PAC ID: 6901146976 Enrollment ID: I20190329001069 |
| Provider Name | Julie Jeanette King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700156437 PECOS PAC ID: 8123307147 Enrollment ID: I20190717001370 |
| Provider Name | Charles A. Kip Griffith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720466675 PECOS PAC ID: 4385065945 Enrollment ID: I20200607000033 |
| Provider Name | Cindy Lee Wallace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114395274 PECOS PAC ID: 8820411382 Enrollment ID: I20200701000829 |
| Provider Name | Kimberly Sue Newman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164896643 PECOS PAC ID: 2264858117 Enrollment ID: I20200821002447 |
| Provider Name | Priscilla Kneipp Cancado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457987984 PECOS PAC ID: 6103243274 Enrollment ID: I20200903001838 |
| Provider Name | Vicki Jo Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700302809 PECOS PAC ID: 1658751342 Enrollment ID: I20220712003035 |
| Provider Name | Brooke Jensen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053949552 PECOS PAC ID: 4688055379 Enrollment ID: I20220712003352 |
| Provider Name | Marisa Kay Alder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851718324 PECOS PAC ID: 0042687089 Enrollment ID: I20221104001120 |
| Provider Name | Jennifer Lynne Parker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346776671 PECOS PAC ID: 5193172260 Enrollment ID: I20231110000990 |
| Provider Name | Lloyd Joseph Stanton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760098842 PECOS PAC ID: 8325498512 Enrollment ID: I20231229002875 |
| Provider Name | Joshua Woodland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689429680 PECOS PAC ID: 1951846997 Enrollment ID: I20240714000111 |
| Provider Name | Jennylyn Hammond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619736253 PECOS PAC ID: 9830638071 Enrollment ID: I20240830003276 |
| Provider Name | Stefani Solorzano Hansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699478313 PECOS PAC ID: 2668908302 Enrollment ID: I20241205000680 |
| Provider Name | Halie Elizabeth Checketts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194175463 PECOS PAC ID: 6204353600 Enrollment ID: I20250508003082 |
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