Provider Demographics
NPI:1881061273
Name:BEUS, PARKER REY
Entity type:Individual
Prefix:
First Name:PARKER
Middle Name:REY
Last Name:BEUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 W 340 N
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84335-9300
Mailing Address - Country:US
Mailing Address - Phone:435-279-0001
Mailing Address - Fax:435-752-7433
Practice Address - Street 1:621 W 340 N
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:UT
Practice Address - Zip Code:84335-9300
Practice Address - Country:US
Practice Address - Phone:435-279-0001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-01
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10834430-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty