Provider Demographics
NPI:1578579520
Name:COX, SERIANNA BREWER (CMHC)
Entity Type:Individual
Prefix:
First Name:SERIANNA
Middle Name:BREWER
Last Name:COX
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:SERIANNA
Other - Middle Name:
Other - Last Name:GREGG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:4460 S HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-3543
Mailing Address - Country:US
Mailing Address - Phone:801-784-5960
Mailing Address - Fax:
Practice Address - Street 1:1785 E 1450 S STE 300
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015-2299
Practice Address - Country:US
Practice Address - Phone:801-784-5960
Practice Address - Fax:801-784-5980
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5367161-3503101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty