Healthcare Provider Details

I. General information

NPI: 1336013465
Provider Name (Legal Business Name): MELISSA CORI CAREY CPSS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1085 S BLUFF ST
ST GEORGE UT
84770-5245
US

IV. Provider business mailing address

3424 S RIVER RD UNIT E5
ST GEORGE UT
84790-6262
US

V. Phone/Fax

Practice location:
  • Phone: 435-674-9999
  • Fax:
Mailing address:
  • Phone: 435-256-4532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberF24-115067
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number2746
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: