Healthcare Provider Details

I. General information

NPI: 1043559594
Provider Name (Legal Business Name): DEVIN MONAHAN CMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2013
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 N FREEDOM BLVD STE 300
PROVO UT
84601-1690
US

IV. Provider business mailing address

1036 NEVADA AVE
PROVO UT
84606-6320
US

V. Phone/Fax

Practice location:
  • Phone: 801-373-4760
  • Fax: 801-373-0639
Mailing address:
  • Phone: 801-885-2037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8743584-6004
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: