MEDICARE: ANDREA BARSS HIGH 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	8166690-6004	UT

General Provider Information

NPI Number	:	1730514324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA BARSS HIGH CMHC

Provider Business Mailing Address
First Line	:	1583 CRESTMONT WAY
Second Line	:
City	:	KAYSVILLE
State	:	UT
Zip	:	84037-9410
Country	:	US
Telephone Number	:	801-815-5214
Fax Number	:

Provider Business Practice Location Address
First Line	:	4043 RIVERDALE RD # 1081
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84405-1717
Country	:	US
Telephone Number	:	801-513-1049
Fax Number	:

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

Provider Enumeration Date	:	09/13/2013
Last Update Date	:	08/31/2023

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