BLAKE THOMAS HALLIDAY (NPI# 1710068473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710068473 |
| Entity Type | Individual |
| Full Name | BLAKE THOMAS HALLIDAY |
| Credential | LMFT |
| Practice Address |
5149 S 1500 W Riverdale UT 84405-3926 |
| Practice Telephone | 8014750402 |
| Practice Fax Number | 8014757464 |
| Mailing Telephone | 8014750402 |
| Mailing Fax Number | 8014757464 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2010-01-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 5989003-3902 | UT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | 260022408 | 01 | |
| UT | 876000308007 | 05 |
| Street Address |
5149 S 1500 W |
| City | RIVERDALE |
| State | UT |
| Zip Code | 84405-3926 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700882172 | B. Shane Harmon | Social Worker | 5149 S 1500 W, Riverdale, UT 84405-3926 | 2005-06-21 |
| 1669726741 | Angie Berry | Marriage & Family Therapist | 5149 S 1500 W, Riverdale, UT 84405-3926 | 2012-10-29 |
| 1487933909 | Taylor Cameron Herrin | Marriage & Family Therapist | 5149 S 1500 W, Riverdale, UT 84405-3926 | 2011-08-15 |
| 1417235284 | Cheryl Kelstrom-smith Lcsw, LLC | Social Worker | 5149 S 1500 W, Riverdale, UT 84405-3926 | 2011-07-28 |
| 1326326273 | B. Shane Harmon Lcsw, LLC | Social Worker | 5149 S 1500 W, Riverdale, UT 84405-3926 | 2011-07-26 |
| 1740335850 | Cheryl Kelstrom Smith | Counselor | 5149 S 1500 W, Riverdale, UT 84405 | 2007-01-25 |
| 1053466169 | Theresa Stueland Kay | Psychologist | 5149 S 1500 W, Riverdale, UT 84405 | 2007-01-25 |
| 1760588818 | Lee Legrand Perry | Social Worker | 5149 S 1500 W, Riverdale, UT 84405-3926 | 2006-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669028171 | Alyssa House | Behavioral Analyst | 4933 1500 West #110, Riverdale, UT 84405 | 2019-08-12 |
| 1518525989 | Petersen Farms Assisted Living & Memory Care | Assisted Living Facility | 6980 S. 475 E., South Weber, UT 84405 | 2019-05-31 |
| 1376038141 | National Vision, Inc. | Technician/Technologist | 821 West Riverdale Road, Riverdale, UT 84405 | 2018-06-25 |
| 1194218461 | South Weber City | Ambulance | 7365 S 1375 E, South Weber, UT 84405 | 2018-06-12 |
| 1528572682 | Sandra Jo Scott | Dental Hygienist | 264 W Ridgeline Dr, Washington Terrace, UT 84405 | 2017-11-28 |
| 1376079061 | Loretta Shupe | Registered Nurse | 5319 S 500 E, Ogden, UT 84405 | 2017-05-02 |
| 1134661374 | Randy Ferrin | Registered Nurse | 5697 Maplewood Drive, South Ogden, UT 84405 | 2016-11-04 |
| 1871046284 | Karla Rosen | Counselor | 5202 S. Freeway Park Dr., Riverdale, UT 84405 | 2016-08-02 |
| 1053784520 | Jenifer Rebecca Nilson Smith | Physical Therapist | 5648 S. Adams Ave, Washington Terrace, UT 84405 | 2015-11-05 |
| 1972976454 | Jenniferlyn Fletcher | Physical Therapy Assistant | 5648 South Adams Ave, Washington Terrace, UT 84405 | 2015-11-05 |
| Find all providers in zip 84405 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205451960 | Amanda Nicole Nicholson | Marriage & Family Therapist | 269 Highway 138 Sw Apt 902, Riverdale, GA 30274-4064 | 2020-06-09 |
| 1669726741 | Angie Berry | Marriage & Family Therapist | 5149 S 1500 W, Riverdale, UT 84405-3926 | 2012-10-29 |
| 1487933909 | Taylor Cameron Herrin | Marriage & Family Therapist | 5149 S 1500 W, Riverdale, UT 84405-3926 | 2011-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205433497 | Malory Christensen | Marriage & Family Therapist | 12401 S 450 E Unit D2, Draper, UT 84020-7938 | 2020-10-01 |
| 1285241109 | Sunset Counseling Services, LLC | Marriage & Family Therapist | 2326 N 400 E Ste 205, Tooele, UT 84074-3457 | 2020-09-24 |
| 1699387134 | Amanda Butler | Marriage & Family Therapist | 9035 S 1300 E Ste 120, Sandy, UT 84094-3192 | 2020-08-17 |
| 1598374134 | Troy Faddis, Lmft - Pllc | Marriage & Family Therapist | 72 W Patriot Way Unit 1139, Richfield, UT 84701-1888 | 2020-07-29 |
| 1275158974 | Magnum Morgan | Marriage & Family Therapist | 1760 N Main St Ste 105, Cedar City, UT 84721-7807 | 2020-06-09 |
| 1265052880 | Sarah Dawn Finney | Marriage & Family Therapist | 3390 S Oakwood St, Salt Lake City, UT 84109-3073 | 2020-04-23 |
| 1184243222 | John Patterson | Marriage & Family Therapist | 199 290 West Ste. 150, Lindon, UT 84042 | 2020-04-09 |
| 1477188209 | Sarah Rawlings | Marriage & Family Therapist | 24 W Sergeant Court Dr Ste 202, Saratoga Springs, UT 84045-5809 | 2020-03-12 |
| 1255965141 | Brian Rhodes | Marriage & Family Therapist | 1460 S Providence Center Dr Ste 2, Cedar City, UT 84720-1981 | 2020-02-28 |
| 1922639186 | Brent Esplin | Marriage & Family Therapist | 626 N 1170 E, Orem, UT 84097-4430 | 2020-01-27 |
| Find all providers with the same taxonomy | ||||
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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.