Provider Demographics
NPI:1083903926
Name:ROBINSON, BLU RYAN (CMHC)
Entity Type:Individual
Prefix:
First Name:BLU
Middle Name:RYAN
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 TOWN AND COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-3220
Mailing Address - Country:US
Mailing Address - Phone:801-319-7170
Mailing Address - Fax:
Practice Address - Street 1:1875 S STATE ST STE T500
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-8090
Practice Address - Country:US
Practice Address - Phone:801-319-7170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5715062101YA0400X
UT5715062-6004101YM0800X
UT715062-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)