Shelton, Mark Jim
Shelton, Mark Jim is an individual health care provider with primary practice located at 100 S 1000 W , Tooele UT 84074-4010. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Shelton, Mark Jim can be contacted via phone (435) 843-3520.Contact Information
Primary practice address
100 S 1000 W
Tooele UT 84074-4010
Phone: (435) 843-3520
Fax: (435) 843-3555
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 128877-3501 | Utah |
Profile Details
| NPI number | 1770554289 |
|---|---|
| LBN Legal business name | Shelton, Mark Jim |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 1st, 2006 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770554289 | NPPES |
| Utah | Other | 942938348006 | CHAMPUS |
| Utah | Other | R95603 | CHAMPUS |
| Utah | Other | 107000925101 | CHAMPUS |
| Utah | Other | 942938348SH1 | CHAMPUS |
| Utah | Other | 292738 | CHAMPUS |
Popular Providers
-
Starr, Trenton D.
100 S 1000 W , Tooele UT 84074-4010 -
Smart, Stephanie Ann
312 S Main St , Tooele UT 84074-2746 -
Debois, Sarah Louise
100 S 1000 W , Tooele UT 84074-4010 -
Thomas, Douglas Paul
100 S 1000 W , Tooele UT 84074-4010 -
Parry, Odbayar Jigjidsuren
100 S 1000 W , Tooele UT 84074-4010 -
Groves, Denise
50 N Main St , Tooele UT 84074-2139 -
Hakes, Chris Corey
50 N Main St , Tooele UT 84074-2139 -
Walters, John L
134 W 1180 N Suite 4, Tooele UT 84074-1483