Healthcare Provider Details

I. General information

NPI: 1114661097
Provider Name (Legal Business Name): JEFFREY ROBISON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2022
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 S 100 E
PAYSON UT
84651-2252
US

IV. Provider business mailing address

656 S 800 W
SPRINGVILLE UT
84663-5949
US

V. Phone/Fax

Practice location:
  • Phone: 801-382-9338
  • Fax:
Mailing address:
  • Phone: 435-253-1745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13773297-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: