Provider Demographics
NPI:1336900042
Name:MONSON, BRIAN PETER (ACMHC, MPA)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:PETER
Last Name:MONSON
Suffix:
Gender:M
Credentials:ACMHC, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 E 300 S STE 106
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3845
Mailing Address - Country:US
Mailing Address - Phone:801-980-2566
Mailing Address - Fax:
Practice Address - Street 1:2046 E MURRAY HOLLADAY RD STE 101
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84117-5173
Practice Address - Country:US
Practice Address - Phone:801-980-2566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5628318-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health