MEDICARE: MR. NEAL HOPKINS 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	8695141-6004	UT

General Provider Information

NPI Number	:	1851849053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NEAL HOPKINS CMHC

Provider Business Mailing Address
First Line	:	2550 WASHINGTON BLVD STE 200
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84401-3121
Country	:	US
Telephone Number	:	801-621-8670
Fax Number	:	801-621-4512

Provider Business Practice Location Address
First Line	:	2550 WASHINGTON BLVD STE 200
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84401-3121
Country	:	US
Telephone Number	:	801-621-8670
Fax Number	:	801-621-4512

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

Provider Enumeration Date	:	09/15/2016
Last Update Date	:	09/15/2016

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