Provider Demographics
NPI:1043073810
Name:EVERETT, SANDEE ROE (ACMHC)
Entity Type:Individual
Prefix:
First Name:SANDEE
Middle Name:ROE
Last Name:EVERETT
Suffix:
Gender:F
Credentials:ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 N 300 W STE B
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-3563
Mailing Address - Country:US
Mailing Address - Phone:435-301-3129
Mailing Address - Fax:
Practice Address - Street 1:85 N 300 W STE B
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-3563
Practice Address - Country:US
Practice Address - Phone:435-301-3129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13746381-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health