JAYELYNNE TIDLUND (NPI# 1043695265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043695265 |
| Entity Type | Individual |
| Full Name | JAYELYNNE TIDLUND |
| Practice Address |
1067 E Tabernacle St St George UT 84770-3163 |
| Mailing Address |
6013 S Redwood Rd Taylorsville UT 84123-5220 |
| Practice Telephone | 8012555131 |
| Practice Fax Number | 8012555131 |
| Mailing Telephone | 8012555131 |
| Mailing Fax Number | 8012555131 |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2015-07-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
1067 E TABERNACLE ST |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84770-3163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780686972 | Caroline S Mcfadden | Pharmacist | 1067 E Tabernacle St, St George, UT 84770-3163 | 2005-06-01 |
| 1134579410 | Maryann Mcnamara | Counselor | 1067 E Tabernacle St, Ste 7, St George, UT 84770-3163 | 2016-06-16 |
| 1407206881 | Emily Olsen | Counselor | 1067 E Tabernacle St, Ste 7, St George, UT 84770-3163 | 2016-06-16 |
| 1275981151 | Matthew Mcarthur | Counselor | 1067 E Tabernacle St, Ste 7, St George, UT 84770-3163 | 2016-06-01 |
| 1134577000 | Leanne Johanson | Counselor | 1067 E Tabernacle St, Ste 7, St George, UT 84770-3163 | 2016-06-01 |
| 1831547702 | Christina Howell | Counselor | 1067 E Tabernacle St, Ste 7, St George, UT 84770-3163 | 2016-06-01 |
| 1427406446 | Paula Dick | Counselor | 1067 E Tabernacle St, Ste 7, St George, UT 84770-3163 | 2016-05-31 |
| 1407204423 | Kyna Hafen | Counselor | 1067 E Tabernacle St, Ste 7, St George, UT 84770-3163 | 2016-05-31 |
| 1609230564 | Christopher Weber | Counselor | 1067 E Tabernacle St, Suite 7, St George, UT 84770-3163 | 2016-04-07 |
| 1811358484 | Robin Cusanelli | Counselor | 1067 E Tabernacle St, Suite 7, St George, UT 84770-3163 | 2016-03-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740808500 | Redstone Reference Laboratories Inc | Clinical Medical Laboratory | 556 N Dixie Drive, Suite 2, St George, UT 84770 | 2020-07-08 |
| 1033776315 | Ecko Ashmore | Marriage & Family Therapist | 1173 S. 250 W. Bld 1 Ste 208, St. George, UT 84770 | 2019-05-22 |
| 1740844679 | Amy Darragh | Behavior Technician | 249 E Tabernacle St, Ste 100, St George, UT 84770 | 2019-04-25 |
| 1124598198 | Loren Kyle Gulbranson | Internal Medicine | Dixie Regional Medical Center, 515 South, 300 East, Saint George, UT 84770 | 2018-12-03 |
| 1487150728 | Sound Sleep Medical LLC | Durable Medical Equipment & Medical Supplies | 640 East 700 South Building 2, St. George, UT 84770 | 2018-04-04 |
| 1588162911 | Desert Edge Medical | Family Medicine | 1664 S Dixie Dr Ste D201, St George, UT 84770 | 2018-01-31 |
| 1568981314 | Jeffrey Joseph Peterson | Behavior Technician | 162 N 400 E Ste A-105, St. George, UT 84770 | 2017-09-13 |
| 1992242549 | Zachary Carey | Specialist/Technologist | 1115 W Diamond Valley Dr, Saint George, UT 84770 | 2017-01-20 |
| 1669920427 | Charles Taylor Church | Technician, Other | 474 West 200 East, St. George, UT 84770 | 2016-09-21 |
| 1952755480 | Hollystic Hideaway | Voluntary or Charitable | 1418 W Sunset Blvd. # 2, Saint George, UT 84770 | 2016-04-21 |
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| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053959601 | Mckenzie Morgan | Counselor | 1240 E 100 S Bldg 22 #221, St George, UT 84790-3001 | 2019-12-13 |
| 1841737210 | John Rhodes | Counselor | 6105 S Rimrunner Dr, St George, UT 84790-1238 | 2017-01-24 |
| 1235682345 | Eagle Ranch Outpatient Services | Counselor | 91 W 1470 S, Suite 101, St George, UT 84770-6709 | 2016-07-26 |
| 1750755591 | Nikki Andersen | Counselor | 1492 S Silicon Way, Suite A, St George, UT 84770-7155 | 2015-11-17 |
| 1497126965 | Brenda Mckee | Counselor | 1492 S Silicon Way Ste A, St George, UT 84770-7156 | 2015-10-09 |
| 1891172094 | Summit Behavior Services | Counselor | 598 Sugar Leo Cir, St George, UT 84790-7451 | 2015-04-27 |
| 1508260944 | Tessa Reber | Counselor | 359 E Riverside Dr, St George, UT 84790 | 2014-10-14 |
| 1912281585 | Amy Engle Brotherson | Counselor | 640 E 700 S Ste 205, St George, UT 84770-5732 | 2011-09-30 |
| 1942513916 | Spencer Poulson | Counselor | 652 S Medical Center Dr # 420, St George, UT 84790-7049 | 2010-07-20 |
| 1912168253 | Sasha M Hight | Counselor | 474 W 200 N # 200, St George, UT 84770-4505 | 2008-06-19 |
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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.