Healthcare Provider Details

I. General information

NPI: 1023554441
Provider Name (Legal Business Name): JOSEPHEVE MARTINDALE CMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOSIE MARTINDALE

II. Dates (important events)

Enumeration Date: 01/09/2017
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 MEDICAL DR STE D101
BOUNTIFUL UT
84010-8905
US

IV. Provider business mailing address

4516 S 700 E STE 360
MURRAY UT
84107-8317
US

V. Phone/Fax

Practice location:
  • Phone: 801-683-1062
  • Fax: 801-295-5537
Mailing address:
  • Phone: 385-231-8387
  • Fax: 385-263-9725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10684061-6004
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number01-17-8434
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number10684061-2506
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: