MEDICARE: CHEYENNE EMMONS

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	C15673	NV

General Provider Information

NPI Number	:	1922957968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHEYENNE EMMONS

Provider Business Mailing Address
First Line	:	348 E 600 S
Second Line	:
City	:	ST GEORGE
State	:	UT
Zip	:	84770-3949
Country	:	US
Telephone Number	:	435-705-7574
Fax Number	:	435-249-7010

Provider Business Practice Location Address
First Line	:	840 PINNACLE CT STE 4A
Second Line	:
City	:	MESQUITE
State	:	NV
Zip	:	89027-3322
Country	:	US
Telephone Number	:	435-705-7574
Fax Number	:	435-249-7010

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

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	01/23/2026

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Directions to “ CHEYENNE EMMONS ” Practice Location

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