Healthcare Provider Details

I. General information

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

Provider Other Name: JOSEPHEVE MARTINDALE BCBA

II. Dates (important events)

Enumeration Date: 01/09/2017
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7533 S CENTER VIEW CT # 6311
WEST JORDAN UT
84084-5526
US

IV. Provider business mailing address

7533 S CENTER VIEW CT # 6311
WEST JORDAN UT
84084-5526
US

V. Phone/Fax

Practice location:
  • Phone: 801-877-0079
  • Fax:
Mailing address:
  • Phone: 801-877-0079
  • Fax: 877-940-4065

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 Code103K00000X
TaxonomyBehavior Analyst
License Number10684061-2506
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: