MR. SHAWN MCMILLEN (NPI# 1750811899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750811899 |
| Entity Type | Individual |
| Full Name | MR. SHAWN MCMILLEN |
| Credential | LASUDC |
| Practice Address |
411 N Grant St Salt Lake City UT 84116-2725 |
| Practice Telephone | (801) 359-8862 |
| Mailing Telephone | 8013598862 |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2017-06-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
312170-6008 | UT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | HT005146-001 | 05 |
| Street Address |
411 N GRANT ST |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84116-2725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174662282 | Sam Leslie Farris | Counselor | 411 N Grant St, Salt Lake City, UT 84116-2725 | 2007-02-05 |
| 1972144731 | Daisy Elizabeth Mae Lael | Counselor | 411 N Grant St, Salt Lake City, UT 84116-2725 | 2019-10-03 |
| 1871059139 | Joel Arvizo | Case Manager/Care Coordinator | 411 N Grant St, Salt Lake City, UT 84116-2725 | 2019-02-12 |
| 1477023497 | Thomas Childs | Psychologist | 411 N Grant St, Salt Lake City, UT 84116-2725 | 2018-12-03 |
| 1356827315 | Jeanine Kunshek | Case Manager/Care Coordinator | 411 N Grant St, Salt Lake City, UT 84116-2725 | 2018-07-12 |
| 1598250060 | Alex Ryan Stephens | Case Manager/Care Coordinator | 411 N Grant St, Salt Lake City, UT 84116-2725 | 2018-06-27 |
| 1053810648 | Kathryn Anne Tozzi | Social Worker | 411 N Grant St, Salt Lake City, UT 84116-2725 | 2018-02-08 |
| 1669983417 | Thomas Evan Mullaly | Peer Specialist | 411 N Grant St, Salt Lake City, UT 84116-2725 | 2017-10-19 |
| 1760926562 | Janie Hansen | Social Worker | 411 N Grant St, Salt Lake City, UT 84116-2725 | 2016-12-13 |
| 1720522618 | First Step House | Substance Abuse Rehabilitation Facility | 411 N Grant St, Salt Lake City, UT 84116-2725 | 2016-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689281818 | Devery White | Case Manager/Care Coordinator | 195 N 1900 W, Salt Lake City, UT 84116 | 2020-10-01 |
| 1114402377 | Felicia Marie Speer | Community Health Worker | 1303 Sir Phillip Dr, Salt Lake City, UT 84116 | 2018-10-03 |
| 1982144341 | Sharlena Schacht | Pharmacy Technician | 1040 North 2200 West, Salt Lake City, UT 84116 | 2017-03-06 |
| 1316300460 | Riverside Family Dental Care, Inc | Clinic/Center | 1614 W 700 N, Salt Lake City, UT 84116 | 2016-04-05 |
| 1174882856 | Marilyn Ross | Nurse Practitioner | 384 Wright Brothers Dr., Marilyn Ross Bld #2, Salt Lake City, UT 84116 | 2012-05-15 |
| 1720387137 | Lifetime Products Inc. | Durable Medical Equipment & Medical Supplies | 745 N Warm Springs Rd, Salt Lake City, UT 84116 | 2011-03-24 |
| 1811000276 | Kim Coston Christensen | Preventive Medicine | 2150 West 700 North, Kim C. Christensen D.o. Faa Sl/artcc Mfo, Salt Lake City, UT 84116 | 2006-08-17 |
| 1144705583 | Brian Larry Gashler | Family Medicine | 54 N 8th W, Salt Lake City, UT 84116 | 2018-10-02 |
| 1528350972 | Aliesha Shaw | Student in an Organized Health Care Education/Training Program | 26 South 2000 East, 5900, Salt Lake City, UT 84116 | 2011-05-04 |
| 1427035187 | Sarah Lynn Woolsey | Family Medicine | 1365 W 1000 N, Salt Lake City, UT 84116 | 2005-12-23 |
| Find all providers in zip 84116 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063995538 | Latino Behavioral Health Services | Counselor | 3471 S West Temple, Salt Lake City, UT 84115-4338 | 2018-09-11 |
| 1891299012 | Sherrie Lynn Bolton | Counselor | 2001 S State St # S2-300, Salt Lake City, UT 84190-0001 | 2018-03-21 |
| 1215273529 | Holly H Tanski | Counselor | 5770 S. 1500 W. Bld A, Ihc Wasatch Canyons Campus, Salt Lake City, UT 84119 | 2012-12-14 |
| 1538415138 | Dominic Falsone | Counselor | 3846 Villa Dr, Salt Lake City, UT 84109 | 2012-08-01 |
| 1083976690 | Karen Lenore Stovall | Counselor | 2200 S State St, Salt Lake City, UT 84115-2724 | 2012-06-10 |
| 1407124662 | Daniel Wallace Powell | Counselor | 655 S State St, Salt Lake City, UT 84111-3819 | 2011-12-02 |
| 1902102858 | Annette Milner | Counselor | 2558 S 900 E Ste B, Salt Lake City, UT 84106-2239 | 2011-02-09 |
| 1235434291 | Cody Feda | Counselor | 344 East 100 South, Salt Lake City, UT 84111 | 2011-01-21 |
| 1841593266 | Edward Henry Snoddy | Counselor | 415 W 400 S, Salt Lake City, UT 84101-1135 | 2010-12-07 |
| 1114227766 | Rebecca Jo Breiman | Counselor | 514 Wilson Ave, Salt Lake City, UT 84105-2912 | 2010-10-29 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84116 |
Please comment or provide details below to improve the information on MR. SHAWN MCMILLEN.
| 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.