WYATT MONTGOMERY (NPI# 1881101004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881101004 |
| Entity Type | Individual |
| Full Name | WYATT MONTGOMERY |
| Practice Address |
1755 N 200 E Logan UT 84341-1915 |
| Mailing Address |
971 S 800 W Brigham City UT 84302-3042 |
| Practice Telephone | 4357536245 |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2018-01-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
1755 N 200 E |
| City | LOGAN |
| State | UT |
| Zip Code | 84341-1915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669799912 | Reva C Rosenband | Marriage & Family Therapist | 1755 N 200 E, Logan, UT 84341-1915 | 2010-04-27 |
| 1376017475 | Kierstin Thigpen | Community Health Worker | 1755 N 200 E, Logan, UT 84341-1915 | 2019-01-11 |
| 1730652884 | Tate Kennedy Larson | Community Health Worker | 1755 N 200 E, Logan, UT 84341-1915 | 2019-01-10 |
| 1891296893 | Jentrie Taylor Hales | Community Health Worker | 1755 N 200 E, Logan, UT 84341-1915 | 2018-02-24 |
| 1518468511 | Spencer Brock Egan | Community Health Worker | 1755 N 200 E, Logan, UT 84341-1915 | 2018-02-24 |
| 1982104972 | Kemyla Sacre | Community Health Worker | 1755 N 200 E, Logan, UT 84341-1915 | 2018-02-15 |
| 1205344645 | Brandon C Miller | Foster Care Agency | 1755 N 200 E, Logan, UT 84341-1915 | 2018-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701529 | Aubrey Salmond | Registered Nurse | 500 East 1500 N, Logan, UT 84341 | 2019-10-11 |
| 1043702046 | Eye Pros of Logan LLC | Optometrist | 1475 N Main St Ste 103, Logan, UT 84341 | 2018-06-05 |
| 1275050452 | Rylie Jeanne Cook | Student in an Organized Health Care Education/Training Program | 11 Aggie Village Apt. J, Logan, UT 84341 | 2017-08-28 |
| 1093262156 | Jessica Lynn Mcgarry | Social Worker | 1040 N 130 W, Apt 100, Logan, UT 84341 | 2016-09-07 |
| 1740663566 | Paul R Gregory | Occupational Therapy Assistant | 1300 N 500 E Suite 120, Suite 120, Logan, UT 84341 | 2015-06-30 |
| 1851708846 | Bradley Budge | Optometrist | 535 E 1400 N Ste 130, Logan, UT 84341 | 2014-07-22 |
| 1386058709 | Daniel Raymond Carlson | Physician Assistant | 500 E. 1400 N., Logan, UT 84341 | 2014-06-13 |
| 1902220239 | Work Injury Solutions Inc. | Clinic/Center | 630 E 1400 N Ste 140, Logan, UT 84341 | 2014-02-06 |
| 1750627287 | Lee Martin Williams Sr. | Counselor | 186 E. 1800 N., North Logan, UT 84341 | 2013-01-03 |
| 1669747804 | Ronald J Payne | Internal Medicine | 1726 North 1850 East, North Logan, UT 84341 | 2012-03-21 |
| Find all providers in zip 84341 | ||||
| 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 |
|---|---|---|---|---|
| 1609349554 | Kaleb Parry | Counselor | 1755 N 200 E Bsmt, Logan, UT 84341-1915 | 2019-01-03 |
| 1437641669 | Truddy Ketchersid | Counselor | 710 Stratton St, Logan, WV 25601-4015 | 2018-06-04 |
| 1811229354 | Joshua D. Hoyt | Counselor | 2072 N Main St, Logan, UT 84341-1993 | 2010-02-09 |
| 1386266708 | Tyler Richardson | Counselor | 180 S 600 W, Logan, UT 84321-5026 | 2020-05-07 |
| 1407404791 | Cheryl Thacker | Counselor | 312 Hudgins St, Logan, WV 25601-3534 | 2019-08-29 |
| 1215594635 | Simone Yvonne Regan | Counselor | 19 W Center St Ste 201, Logan, UT 84321-5803 | 2019-05-21 |
| 1396219226 | Taylor A Weidner | Counselor | 541 Sr 664 N, Suite C, Logan, OH 43138 | 2019-01-14 |
| 1083112148 | Sierra Schaaf | Counselor | 30381 Chieftain Dr, Logan, OH 43138 | 2018-01-24 |
| 1811403579 | Boni J Probasco | Counselor | 33 W 2nd St, Logan, OH 43138-1886 | 2017-12-18 |
| 1427367044 | Krystal Nadine Abraham | Counselor | 655 E 1300 N, Logan, UT 84341 | 2010-09-30 |
| Find all providers in LOGAN | ||||
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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.