| Sundance Behavioral Resources, Llc | |
|
845 E 4800 S Suite 200 Murray UT 84107-5049 | |
| (801) 264-9522 | |
| (801) 265-9604 |
| Full Name | Sundance Behavioral Resources, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 845 E 4800 S, Murray, Utah |
| Authorized Official Name and Position | Elisabeth Pesce (CEO) |
| Authorized Official Contact | 9046054986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sundance Behavioral Resources, Llc 845 E 4800 S Suite 200 Murray UT 84107-5049 Ph: (801) 264-9522 | Sundance Behavioral Resources, Llc 845 E 4800 S Suite 200 Murray UT 84107-5049 Ph: (801) 264-9522 |
| NPI Number | 1326157355 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 12/22/2022 |
| Certification Date | 10/31/2022 |
| Medicare PECOS PAC ID | 5496979239 |
|---|---|
| Medicare Enrollment ID | O20140617001287 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326157355 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Margaret M Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407839236 PECOS PAC ID: 2961303854 Enrollment ID: I20040114000595 |
| Provider Name | Julie Ann Wiese |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417931296 PECOS PAC ID: 1153311717 Enrollment ID: I20040514001127 |
| Provider Name | Alison Musso |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346230802 PECOS PAC ID: 5092786921 Enrollment ID: I20040804000804 |
| Provider Name | Thomas M Reid |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053381194 PECOS PAC ID: 8628017803 Enrollment ID: I20050427000645 |
| Provider Name | Vaughn S Roche |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649249137 PECOS PAC ID: 1153345111 Enrollment ID: I20060118000347 |
| Provider Name | Douglas D Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356327084 PECOS PAC ID: 2567567001 Enrollment ID: I20070412000087 |
| Provider Name | Carolyn Heninger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891864567 PECOS PAC ID: 4981829272 Enrollment ID: I20140630000457 |
| Provider Name | Tamara Lin Vitela |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285842435 PECOS PAC ID: 6800954066 Enrollment ID: I20141002000422 |
| Provider Name | Duane R Banks |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013092360 PECOS PAC ID: 1456459171 Enrollment ID: I20141122000021 |
| Provider Name | Tamara Lynn Broadhead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124548789 PECOS PAC ID: 4183981665 Enrollment ID: I20171208002076 |
| Provider Name | Cristie Frey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083099139 PECOS PAC ID: 5890045405 Enrollment ID: I20180831001300 |
| Provider Name | Teresa Galloway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285933614 PECOS PAC ID: 7012349228 Enrollment ID: I20191108001346 |
| Provider Name | Richard L Pohl |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306823331 PECOS PAC ID: 6204727118 Enrollment ID: I20191126002365 |
| Provider Name | Michael Ah You |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396412698 PECOS PAC ID: 1456758028 Enrollment ID: I20210923003006 |
| Provider Name | Tara Rainey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235752536 PECOS PAC ID: 6002268059 Enrollment ID: I20240116001941 |
| Provider Name | Brigitte Rose Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831697671 PECOS PAC ID: 3870945843 Enrollment ID: I20240116002478 |
| Provider Name | Bobette Page |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316052319 PECOS PAC ID: 2466628912 Enrollment ID: I20240116003765 |
| Provider Name | Megan Manning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497093561 PECOS PAC ID: 8921332966 Enrollment ID: I20240118004221 |
| Provider Name | Mark Barnhurst |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366885519 PECOS PAC ID: 6204288640 Enrollment ID: I20240122001196 |
| Provider Name | Martin Robert Sheeran |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750657862 PECOS PAC ID: 1759734353 Enrollment ID: I20240131000799 |
| Provider Name | Benjamin Ashby Sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790460269 PECOS PAC ID: 4183077662 Enrollment ID: I20240131003957 |
| Provider Name | Loren D Mitchell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932342516 PECOS PAC ID: 7719102144 Enrollment ID: I20240208003409 |
| Provider Name | Taylor Lola Sublett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821763822 PECOS PAC ID: 1759724404 Enrollment ID: I20240209000233 |
| Provider Name | Tara Lemley Jensen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982970026 PECOS PAC ID: 5991149361 Enrollment ID: I20240214001590 |
| Provider Name | Michelle J Nixon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760695837 PECOS PAC ID: 2466896097 Enrollment ID: I20240221004415 |
Sego Lily Center For The Abused Deaf Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6526 S State St, 404, Murray, UT 84107 Phone: 888-328-5486 Fax: 888-328-5486 | |
Blue Autism Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1233 W Brister Dr, Murray, UT 84123 Phone: 925-338-4764 | |
Community Treatment Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3944 S 400 E, Murray, UT 84107 Phone: 801-261-1442 Fax: 801-261-9569 | |
Meridian Counseling: Individual And Family Therapy, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4516 S 700 E Ste 170, Murray, UT 84107 Phone: 323-332-9905 | |
4 Healing Center Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 45 E Vine St, Murray, UT 84107 Phone: 801-266-4643 Fax: 801-266-4775 | |
Whitehawk Consulting, P.c. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5801 Fashion Blvd, Suite 250, Murray, UT 84107 Phone: 801-913-5543 | |
Live For Life Aspen, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 179 W Winchester St, Murray, UT 84107 Phone: 801-666-6834 |