MEDICARE: MICHAEL SCOTT MEIN CMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	90881526009	UT

General Provider Information

NPI Number	:	1104278076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL SCOTT MEIN CMHC

Provider Business Mailing Address
First Line	:	2655 S LAKE ERIE DR STE B
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-7351
Country	:	US
Telephone Number	:	385-441-4900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2655 S LAKE ERIE DR STE B
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-7351
Country	:	US
Telephone Number	:	385-441-4900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2016
Last Update Date	:	01/31/2026

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