Provider Demographics
NPI:1790125730
Name:GOUVEIA, JOSEPH REGANALBERTO (CMHC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:REGANALBERTO
Last Name:GOUVEIA
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 1:6000 S FASHION BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5435
Mailing Address - Country:US
Mailing Address - Phone:801-520-7938
Mailing Address - Fax:800-528-1208
Practice Address - Street 1:2156 W 6000 S
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067-1426
Practice Address - Country:US
Practice Address - Phone:801-520-7938
Practice Address - Fax:800-528-1208
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8598292-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health