Ctr Supports is a Counselor Clinic in South Jordan, Utah. It is located at 10182 S Campden Ct, South Jordan, UT and its contact number is 801-788-4988. The authorized person for Ctr Supports is Cobilynn R Dickinson
who is Executive Director of the clinic and his/her contact number is 801-450-3164. Ctr Supports Clinic has individuals who are licensure in clinical psychology and has done specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology. Neuropsychology is a specialty within the field of psychology focusing primarily on neurobehavioral functioning.
Complete Clinic Profile:
Ctr Supports Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Ctr Supports
Specialization:
Clinical Neuropsychologist
Clinic Address:
10182 S Campden Ct, South Jordan, Utah, 84009-7109
Phone:
801-788-4988
Fax:
801-206-3588
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Cobilynn R Dickinson
Position:
Executive Director
Contact Number:
801-450-3164
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Ctr Supports clinic are as mentioned below.
NPI Number:
1497254304
NPI Enumeration Date:
06 Feb, 2018
NPI Last Update On:
06 Feb, 2018
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Ctr Supports are as mentioned below.
Specialization
License Number
State
Status
Cognitive & Behavioral
Primary
Clinical Neuropsychologist
Secondary
Behavioral Analyst
Secondary
Clinical
Secondary
Clinical Child & Adolescent
Secondary
Mental Retardation & Developmental Disabilities
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
325706-2501
Other
Utah
License Psychologist
1658550246
Medicaid
Utah
12195372
Other
Caqh
325706-2506
Other
Utah
Behavior Analyst
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Ctr Supports 10182 S Campden Ct, South Jordan, Utah
Zip:
84009-7109
Phone Number:
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Fax Number:
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Patients can reach Ctr Supports at 10182 S Campden Ct, South Jordan, Utah or can call to book an appointment on 801-788-4988. *Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 December, 2024.