Healthcare Provider Details

I. General information

NPI: 1477964765
Provider Name (Legal Business Name): PAUL GAVIN CMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

474 W 200 N
SAINT GEORGE UT
84770-4505
US

IV. Provider business mailing address

474 W 200 N
ST GEORGE UT
84770-4505
US

V. Phone/Fax

Practice location:
  • Phone: 435-634-5666
  • Fax: 435-986-8702
Mailing address:
  • Phone: 435-634-5666
  • Fax: 435-986-8702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5850598-6009
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: