Provider Demographics
NPI:1942472451
Name:WARHURST, TINA MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE
Last Name:WARHURST
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 COLUMBIA WAY
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-2850
Mailing Address - Country:US
Mailing Address - Phone:435-592-4030
Mailing Address - Fax:
Practice Address - Street 1:1156 S BENTLEY BLVD STE 2C
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-1809
Practice Address - Country:US
Practice Address - Phone:435-592-4030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8187115-3502101YM0800X, 1041C0700X
UT8187115-3503104100000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator