PROFESSIONAL CLINICAL MANAGEMENT (NPI# 1023263191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023263191 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL CLINICAL MANAGEMENT |
| Other Organization Name | PREFERRED FAMILY CLINIC |
| Practice Address |
1355 N University Ave Ste 200 Provo UT 84604-2721 |
| Practice Telephone | 8012210223 |
| Practice Fax Number | 8012210291 |
| Mailing Telephone | 8012210223 |
| Mailing Fax Number | 8012210291 |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2008-11-17 |
| Authorized Official Name | MR. RANDALL F HYDE (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 8012210223 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 851131532501 | UT | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Preferred Family Clinic | Doing Business As Name - Organization |
| Street Address |
1355 N UNIVERSITY AVE STE 200 |
| City | PROVO |
| State | UT |
| Zip Code | 84604-2721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902429269 | Michael David Nelson II | Counselor | 1355 N University Ave Ste 200, Provo, UT 84604-2721 | 2020-05-21 |
| 1922518356 | Andy Hawkes Skelton | Counselor | 1355 N University Ave Ste 200, Provo, UT 84604-2721 | 2017-10-12 |
| 1740699453 | Rodrigo Veas-wall | Psychologist | 1355 N University Ave Ste 200, Provo, UT 84604-2721 | 2014-08-06 |
| 1831453679 | Laura Brewer Morris | Counselor | 1355 N University Ave Ste 200, Provo, UT 84604-2721 | 2012-06-26 |
| 1497030175 | Gerrad Sheldon Martin | Counselor | 1355 N University Ave Ste 200, Provo, UT 84604-2721 | 2011-10-13 |
| 1053695684 | Sue Gail Middleton | Social Worker | 1355 N University Ave Ste 200, Provo, UT 84604-2721 | 2011-09-30 |
| 1568750578 | Richard Carlisle Tripp | Counselor | 1355 N University Ave Ste 200, Provo, UT 84604-2721 | 2011-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033742887 | Vaughn E Worthen | Psychologist | 1545 Wsc, Provo, UT 84602-7924 | 2020-02-20 |
| 1265071575 | Scott Daly Hosford | Psychologist | 2500 Wsc, Provo, UT 84602 | 2020-01-03 |
| 1528191046 | Steven Arthur Smith | Psychologist | 1559 W 1050 N, Provo, UT 84604-3024 | 2007-03-13 |
| 1255349627 | Robert L. Gleave | Psychologist | Byu - 1500 Wsc, Provo, UT 84602-7906 | 2006-08-03 |
| 1710907795 | Monroe White | Psychologist | 215 W 100 N, Provo, UT 84601-4433 | 2006-07-20 |
| 1548239478 | Edward Alphonse Parent | Psychologist | 3707 N Canyon Rd, Suite 2a, Provo, UT 84604-4592 | 2006-03-14 |
| 1215552179 | Justin Brent Top | Psychologist | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-06-16 |
| 1538710207 | Benjamin Roos | Psychologist | 1300 E Center St, Provo, UT 84606-3554 | 2019-09-24 |
| 1831756360 | New Beginnings Counseling Group | Psychologist | 1881 N 1120 W, Provo, UT 84604-1180 | 2019-05-20 |
| 1194388215 | Nathan Sewell | Psychologist | 1355 N University Ave, Provo, UT 84604-2721 | 2019-04-15 |
| Find all providers in PROVO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.