Provider Demographics
NPI:1780124693
Name:ROCKY MOUNTAIN BEHAVIORAL CONSULTANTS
Entity type:Organization
Organization Name:ROCKY MOUNTAIN BEHAVIORAL CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:M
Authorized Official - Last Name:BURR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:435-691-3223
Mailing Address - Street 1:45 N STATE ST
Mailing Address - Street 2:STE 3
Mailing Address - City:SALINA
Mailing Address - State:UT
Mailing Address - Zip Code:84654-1363
Mailing Address - Country:US
Mailing Address - Phone:435-691-3223
Mailing Address - Fax:435-529-2030
Practice Address - Street 1:45 N STATE ST
Practice Address - Street 2:STE 3
Practice Address - City:SALINA
Practice Address - State:UT
Practice Address - Zip Code:84654-1363
Practice Address - Country:US
Practice Address - Phone:435-691-3223
Practice Address - Fax:435-529-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT341335-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty