CREDENTIAL LIST-March 1, 2016 Clinical Provider
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CREDENTIAL LIST March 1, 2016 NOJOS ADVISORY BOARD MEMBERS Chairperson Wayne H. Arner, LMHC Utah Youth Village 5800 So. Highland Drive SLC, UT 84121 Work: 801-272-9980 Fax: 801-272-9976 warner@youthvillage.org Levels 1,2,3,4 & 5 SBRA & Psychosexual Renew by: 06-20-2016 Juvenile Court Representative Paula Butler 3rd District Juvenile Court Senior Probation Officer 450 So. State Street PO Box 140431 SLC, UT 84114-0431 Work: 801 238-7741 NO FAX!! paulafb@utcourts.gov CREDENTIALING Div. Child and Family Services Representative Ray Harris, LCSW Division of Child and Family Services rayharris@utah.gov 2655 Lake Erie Dr., WVC, UT 84120 Work: 801-952-4110 Fax: 801-952-4101 Levels 1-2-3 Representative Kathy Ockey LDS Family Services 3740 West Market Center Drive Riverton UT 84065 Work: 801 240-9436 Fax: 801 240-9452 ockeykd@ldsfamilyservices.org Levels 1,2 SBRA Renew by: 06/20/2016 Levels 4-5-6 Representative Timothy Fidler Youth Health Associates 501 W 2600 S #200, Bountiful UT 84010 Phone 801-910-7344 Timfidler550@gmail.com Levels 1/2/4/6 Renew by 10/15/2018 Levels 8/JJS Representative Richard Johnston, LPC DJJS- 195 N 1950 W SLC, UT 84116 Work: 801 538-4392 Fax: 801 538-4334 rhjohnst@utah.gov Level 8 Renew by: 08/15/16 At-Large Representative Dave Fowers, LCSW Private Practice Ogden, UT 84403 Work: 801 725-2104 dfowers@gmail.com Renew by: 10/01/2015 Mental Health/Assessments Representative Nicki Hopwood, LCSW HAPTEN Counseling Services 7069 S Highland Dr, Cottonwood Hgts, UT 84121 Work: 801-310-9968 Fax: 801-447-6894 haptennjh@q.com Renew by: 07/18/16 Webmaster Mace Warren, LCSW Alpha Counseling & Treatment 533 26th St, Ste 100, Ogden UT 84401 or Work: 801 645-5455 Fax: 801-394-0394 macewarren@gmail.com Levels 1,2,3,4 and SBRAs Renew by: 11/19/2018 CREDENTIAL LIST-March 1, 2016 Clinical Provider Jenivee Akalis Draper Psychological Services 668 E 12225 S, Ste 202, Draper UT 84020 Phone: 801-619-3569 Ext226 Fax: 801-576-7540 jenivee@draperpsych.com Levels 1,2 Renew by: 10/19/2016 Wayne H. Arner, LMHC 10-20-07 Utah Youth Village 5800 So. Highland Drive SLC, UT 84121 Work: 801-272-9980 Fax: 801-272-9976 warner@youthvillage.org Levels 1,2,3,4 & 5 Testing: SBRA & Psychosexual Renew by: 06/20/2016 Steven H. Astle, LCSW, CAC 4 The Youth Inc. 1344 W. State, Pleasant Grove, UT 84062 Work: 801-785-8870 Fax: 801-785-9454 Steven19761@hotmail.com Levels 4,5 Renew by: 09/19/2016 Robert Banta, LCSW Arrow Point Associates, LLC 8541 S Redwood Road #B1, West Jordan UT 84088 Work: 801-716-0440; 801-838-7945 Fax: 801-208-1011 arrowpoint@xmission.com Levels 1,2 Renew by: 09/19/2016 Kevin N. Barlow, LMFT Youthtrack - Utah 862 S Main St #4 Brigham City, UT 84302 Cell: 435-512-1222 Fax: 435-723-2521 kevin@utah-youthtrack.com Levels 1,2,6 Renew by: 06/18/2018 Brad Benson, LCSW Private Practice PO Box 790007 Vernal, UT 84079 Work: 1 435-621-6142 Fax: 1 435-789-7922 bradgbenson@yahoo.com Level 1,2 Renew by: 01/17/2016 Jennifer Millar-Bevan, LPC, NCC Everest Counseling 4527 S 2300 E Ste 206, Holladay, UT 84117 Work: 801-272-0762 jennifer@everestcounseling.com Levels: 1 & 2, Assessments Renew by: 09/19/2016 Alan W. Brooks, LMFT Alan Brooks Crossroads 5150 Washington Blvd #1 Ogden, UT 84405 Work: 801-337-0067 Fax: 801-337-0070 alan@alanbrookscrossroads.com Levels 1,2,3,4 Renew by: 06/20/2016 Chet D. Brooks, LMFT Alan Brooks Crossroads 5150 Washington Blvd #1 Ogden, UT 84405 Work: 801-337-0067 Fax: 801-337-0070 chet@alanbrookscrossroads.com Levels 1,2,3,4 Renew by: 09/18/2018 Jennifer Brown CMHC LDS Family Services 3740 W Market Center Drive #1200 Riverton UT 84065 Work: 801-240-9436 Fax: 801-240-9452 Jennifer.brown@ldschurch.org Levels 1,2 Renew by: 05/18/2018 2 CREDENTIAL LIST-March 1, 2016 Clinical Provider Cameron Browne Addo Recovery 199 N 290 W Ste150, Lindon UT 84041 Phone 801-406-8994 Cambrowne1@gmail.com Renew by 3/3/19 Mac Butler Kaizen Counseling 4568 Highland Dr. Ste 200, Salt Lake City, UT 84117 Work: 801-860-1351 mac.butler95@yahoo.com Level 2 Renew by: 4/16/2018 Rob Butters, PhD, LCSW Life Matters Counseling & Health Center 740 E. 3900 S. #100, SLC, UT 84107 Work: 801-313-0555 Fax: 801-313-9669 robbutters@lmcounseling.com Levels 1, 2, 3 Renew by: 10/01/2015 Rachelle Colvin Redwood Family Therapy 24 W Sergeant Ct Dr #201, Saratoga Springs 84045 Phone 801-857-1316 Rachelle.l.colvin@gmail.com Renew by 7/16/2018 Dr. Matt Davies 5353 So 960 Ea #230 Murray, UT 84117 Work: 801 263-3335 Fax: 801 263-2845 drmatdavies@yahoo.com Evals Renew by: 11/21/2016 Charles Nelson Davis Weber Human Services 237 26th Street Ogden, UT 84401 Work: 801 625-3768/801 643-1652 Fax: 801-778-6840 charlied@weberhs.org Levels 1,2, SBRAs Renew by: 07/18/2016 Adrienne Duffany, LCSW Wasatch Mental Health – New Vista 1161 Ea. 300 No. Provo, UT 84606 Work: 801-852-4481 Fax: 801-375-4045 aduffany@wasatch.org Levels 1,2,3 Renew by: 07/18/2016 Nadia Ekenstam, LCSW Valley Behavioral Health 1141 Ea. 3900 So. #A-170, SLC, UT 84124 Work: 801-270-6528 Fax: 801-284-4991 nadiae@valleycares.com Levels 1 & 2 Renew by: 02/18/2019 Lani Ete, LPC Professional Counseling Service 3940 West 4100 South, West Valley City, UT 84120 Work: 801 738-8414 Fax: 801 618-0991 l_ete@yahoo.com Levels 1, 2,3 Renew by: 10/15/2018 Justin Fagnant, LCSW Wasatch Mental Health/New Vista 1161 E 300 N, Provo UT 84606 Work: 801-852-4462 Fax: 801-375-4045 jfagnant@wasatch.org Renew by: 06/20/2016 3 CREDENTIAL LIST-March 1, 2016 Clinical Provider Melissa Ferguson, CMHC Pinnacle Point Counseling 7069 S Highland Drive #250 Cottonwood Heights, UT 84121 Work: 801-867-0462 Fax: 801-917-5707 pinnaclepoint@q.com Evaluations, Level 1,2 Renew By: 04/22/2016 Scott Fidler, Psy.D Draper Psychological Services 668 E 12225 S, Suite 202, Draper, UT 84020 Work: 801-619-3569 Fav 801-576-7540 drfidler@draperpsych.com Evaluations, Levels 1 & 2 Renew by: 07/18/2016 Dave Fowers, LCSW Private Practice Ogden, UT 84403 Work: 801 725-2104 Fax: dfowers@gmail.com Renew by: 10/01/2015 Larry S. Fox, Ph.D Psychological Services, L.L.C. 1192 E. Draper Parkway #201,Draper, UT 84020 Work: 801-560-8538 Fax: 866-485-3319 larrysfox@msn.com Testing: Psychosexual & SBRA Renew by: 06/17/2017 Todd Freestone Comprehensive Treatment Clinic 40 We. Cache Valley Blvd. Logan, UT 84341 Work: 435 787-2272 Fax: 435 713-4001 drfreestone@comprehensivetx.com Eval, 2, 3 Renew by: 06/20/2016 Christine Gailey, LPC Youth Health Associates 430 E 450 S, Clearfield UT 84015 Work 801-776-3305 Fax 801-774-9594 Chrisa28@hotmail.com Level 6 Renew by 2/20/2017 C. Maxwell Gale, Psy.D. 2760 Rasmussen Rd., D 210 Park City, UT 84098 Work: 435 645-9237 Fax: 866 829-1206 Max@galeandassociates.net Levels: SBRA’s. 1 and 2 Renew by: 06/20/2016 Brian J. Garlock, LCSW Youth Health Associates 430 Ea. 450 So. Clearfield, UT 84037 Work: 801-776-3305 Fax: 801-774-9594 briangarlock@msn.com Renew by: 10/01/2015 Patrick Gooley Life Matters Counseling 740 Ea. 3900 So. SLC Ut 84107 Work: 801-918-0697 or 313-0555 Fax: 801 313-9669 patgooley@gmail.com Levels 1,2 Renew by: 06/22/2015 Michelle Gourley LCSW, JD Michelle Gourley & Associates - ChoicePoint Clinical Group 1390 So. 100 Ea., SLC, UT 84105 Work: 801-209-2220 Fax: 801-384-0499 mmgourley@comcast.net 1,2,3, Consultant, Assessments Renew by: 06/18/2018 Ryan Grant, LCSW, RPTS-S Primary Children’s Center for Safe and Healthy Families Eccles Primary Children’s Outpatient Services Bldg 81 North Mario Capecchi, Salt Lake City, UT 84102 And Riverton Hospital Outpatient Services 13773 West 12600 South 3rd Floor, Riverton UT 84065 Work: 801-662-3623 or 801-662-3606 Ryan.Grant2@imail.org Levels 1 & 2, Specializes in ages 3-13 Renew by: 06/28/2016 4 CREDENTIAL LIST-March 1, 2016 Clinical Provider Denzil Grimshaw, LCSW Private Practice Celtbard_2000@comcast.net Level 1 and 2, SBRA, and Psychosexual Renew by: 08/15/2016 Austin Haacke Youth Health Associates 195 East 840 South, Orem UT 84057 Phone 801-592-2423 Fax 801-225-7053 austinhaacke@gmail.com Levels 4/5 Renew by: 2/18/2019 B. Shane Harmon A1 Alliance Counseling Services 5149 S 1500 W, Riverdale UT 84405 Phone 801-475-0402 Fax 801-475-7464 5Xback2back48@hushmail.com Levels 1 & 2 Renew by: 06/18/2018 Ted A. Harris, Ph.D. Center for Family Evaluation & Treatment 5691 So. Redwood Rd #16 Taylorsville, UT 84123 Work: 801-265-3895 Fax: 801-263-1265 cfet@sisna.com Levels 1,2,3, Evals Renew by: 09/19/2016 Troy Hartman Youthtrack 693 So. 400 Ea. Brigham City, UT 84302 Work: 435-723-9442 X13 Troy.hartman@rescare.com Level 6 Renew by: 04/16/2018 Rick Hawks Ph.D. 3670 Quincy #101 Ogden, UT 84403 Work: 801 782-3551 Fax: 801 334-4024 drhawks@drrickhawks.com Evals Renew by: 06/17/2017 Matthew Hedelius, PhD Comprehensive Treatment Clinic 40 We. Cache Valley Blvd., S-#10A Logan, UT 84341 SBRA’s, Levels 1,2 Work: 435-787-2272 Fax: 435-713-4001 drhedelius@addictions-healing.com Renew by: 09/18/2017 Nicki Hopwood, LCSW HAPTEN Counseling Services 7069 S Highland Dr, Cottonwood Hgts, UT 84121 Work: 801-310-9968 Fax: 801-447-6894 haptennjh@q.com Levels 1,2,4,5,8, Evals Renew by: 07/18/2016 Kenneth Hull, LPC Adolescence to Adulthood Counseling PO Box 540724 No. Salt Lake, UT 84054 Work: 801 891-0400 Fax: 801 298-0846 KenHullLPC@aac-utah.com Level 2 Renew by: 06/20/2016 Michael D. Jensen, LCSW New Beginnings Family Counseling, LLC 50 S Main St. #25, Manti, UT 84642 Phone; 435-528-7048 Fax: 435-528-7048 Mdjensen64@hotmail.com Levels 1/2 Renew by: 04/16/2018 Richard Johnston, LPC DJJS- 195 N 1950 W SLC, UT 84116 Work: 801 538-4392 Fax: 801 538-4334 rhjohnst@utah.gov Level 8 Renew by: 08/15/16 5 CREDENTIAL LIST-March 1, 2016 Clinical Provider Evan Kenison, LCSW Sunset Counseling Services LLC 2356 No. 400 Ea. #202 Tooele, UT 84074 Phone 435 850-2547 Fax: 435 843-7438 ekenison@q.com Renew by 10/17/2016 Jaynie Kokkola, LCSW Youth Health Associates 836 No. 1375 We. Provo, UT 84604 jayniekokkola@gmail.com Work: 801 375-2523 Renew by: 02/25/2016 DeLynn Lamb Private Practice 3628 S Comstock Rd, Cedar City 84720 Phone 435-590-1923 delynnlamb@hotmail.com 1,2, SBRA’s Renew by 2/26/2019 David J. Lamere Life Matters Counseling 740 Ea. 3900 So. #100, SLC, Ut 84107 Work: 801-313-0555 Fax 801-313-9669 dave@lmcounseling.com Level 2, 3 Renew by: 9/18/2017 Elizabeth Lewin-Shepley, LCSW Wasatch Mental Health 1161 Ea. 300 No. Provo, UT 84606 Work: 801-852-4473 Fax: 801-375-4045 elewin@wasatch.org Levels 1,2,3 Renew by: 08/16/2016 Robert Lindquist, LCSW Wasatch Youth Center 3534 S 700 W, SLC UT 84119 Work 801-265-5830 robbylindquist@utah.gov Level 8 Renew by 2/20/2017 Matt Loveland New Directions Counseling 31 We. Center Street Kaysville, UT 84037 Work: 801 660-5557 Fax: 801 734-8433 newdirections@ymail.com Levels 1/2/SBRA’s Renew by: 04/18/2018 Carol Lundwall, CPCI Intermountain Specialized Abuse Treatment Center 1868 N 1120 W, Provo UT 84604 Work: 801-373-0210 Fax: 801-373-0215 clundwall@gmail.com Levels 1,2 Renew by: 06/17/2017 Michelle Manwaring, LCSW Intermountain Specialized Abuse Tx Ctr 1555 We 2200 So. Suite A, West Valley City 84119 Work: 801-886-8900 Fax: 801-886-8898 And Safe House Counseling 1174 Greystone Way Ste 6, Salt Lake City 84106 Cell: 801-718-9206 mmanwaringisat@gmail.com Levels 1,2 Evals Renew by: 2/18/2019 Stacy A. McKenzie, PhD, CMHC Trauma Awareness & Treatment Center 32 W Winchester, Suite 101, Salt Lake City, UT 84107 Work: 801-263-6367 Fax: 801-263-6370 And Pinnacle Point Counseling 7069 S Highland Drive #250 Cottonwood Heights, UT 84121 stacymckenzie@q.com Levels: 1,2,3,4 & Assessments Renew by: 09/19/2016 6 CREDENTIAL LIST-March 1, 2016 Clinical Provider Kory Meacham, MAEd, LPC Voyager Therapeutic Services 672 W 1000 S Richfield, UT 84701 Work: 435 633-1701 vtstherapy@gmail.com Level 1,2,3 Renew by:: 10/16/2017 Matt Merback, CMHC Youth Health Associates 446 Ea. 450 So. Clearfield UT 84015 Work: 801-706-3034 mmerback@yhautah.com Levels 4, 6 Renew by: 01/17/2016 Ron Mervis, LCSW Wasatch Youth Center 3534 S 700 W SLC, UT 84119 Work: 801-265-5814 Fax: 801-265-5830 rmervis@utah.gov Level 8 Renew by: 04/16/2018 Susan Middleton Preferred Family Clinic 1355 N University Ave #200, Provo UT 84604 Phone 801-221-0223 Fax 801-221-0291 Pfc1355@gmail.com Level 2 Renew by 11/14/2018 Patricia C. Millar, LCSW Weber Human Services 237 26th Street Ogden, UT 84401 Work: 801-625-3753 Fax: 801-778-6840 patm@weberhs.org Levels: Assessments, 1 & 2 Renew by: 07/18/2016 Marina Money, Ph.D Utah Psychological Services 1453 N 1200 W, Orem UT 84057 Work: 801-734-4945 Fax: 801-734-4946 drmarinamoney@gmail.com Levels 1,2, Evals Renew by: 03/19/2016 Jeff Moore, LCSW Alpha Counseling & Treatment 533 26th Street Suite 100 Rm 1, Ogden UT 84401 Work: 385-313-7149 Fax: 801 394-0394 Jeffmoore68@comcast.net Levels 1,2 Renew by: 10/17/2016 Jennie Murdock Child and Family Hope Center 21 N 490 W, American Fork, UT 84003 Work: 801-636-9600 Fax: 801-642-2496 Jenniem1951@gmail.com or Childandfamilycenter@gmail.com Levels: 1, 2 Renew by: 5/18/2018 Mindy Nance, LCSW Youth Health Associates 501 W 2600 S Suite 200, Bountiful, UT 84010 Work: 801-529-7824 Fax: 801-683-8962 mindy@yhautah.com Levels 1-6 Renew by: 10/17/2016 7 CREDENTIAL LIST-March 1, 2016 Clinical Provider David Nichols, LCSW Draper Psychological Services 668 E 12225 S, Suite 202, Draper UT 84020 W 801-669-4999 (c) or 801-619-3569 (office) Fax 801-576-7540 dncounseling@gmail.com Levels 1,2 Renew by 2/20/2017 Steven Norman LDS Family Services 3740 West Market Center Drive Riverton UT 84065 Work: 801 240-9436 Fax: 801 240-9452 normansa@ldsfamilyservices.org Levels 1,2 Renew by: 2/20/2017 Todd Northrup Intermountain Specialized Abuse Treatment 1555 W 2200 S, Ste. A, SLC 84119 Work: 801-886-8900 Fax: 801-886-8898 slcisat@gmail.com Levels 1 and 2 Renew by 10/17/2016 Kathy Ockey LDS Family Services 3740 West Market Center Drive Riverton UT 84065 Work: 801 240-9436 Fax: 801 240-9452 ockeykd@ldsfamilyservices.org Levels 1,2 SBRA Renew by: 06/20/2016 Randall A. Oster, PhD Private Practice 2040 East Murray-Holladay Rd. Suite 220 Holladay, UT 84117 Work: 1 801-878-9027 Fax: 1 801-878-9384 associatedbehavior@yahoo.com Levels Assessments Renew by: 01/17/2016 James C. Otteson, LPC Alliance Clinical Services 71 No. 490 We. American Fork, UT 84003 Work: 801-205-2744 Fax: 801-763-8320 www.allianceyouthservices.com SBRA Evals, Level 6 OR Alliance Youth Services 995 E 1100 N, American Fork, UT 84003 Jamesotteson57@gmail.com Level 6/SBRA Renew by: 02/18/2018 Richard R. Oveson, CPCI Alliance Clinical Services 71 No. 490 We. American Fork, UT 84003 Work: 801-763-7775 Fax: 801-763-7651 rroveson@gmail.com Levels 2/6 Renew by: 02/18/2018 M. Shawn Palau, LCSW Aloha Behavioral Consultants Inc. 707 24th Street, Suite D Ogden, UT 84401 Work: 801-399-1818 Fax: 801-782-8412 abc@alohabehavioral.com Levels 1-3 Renew by: 10/17/2016 Kerry Max Park Child and Family Therapy LLC 21 N 490 W, American Fork UT 84003 Phone 801-636-9600 or 801-592-7876 kmaxpark@gmail.com Level 2 Renew by: 9/26/2018 8 CREDENTIAL LIST-March 1, 2016 Clinical Provider Tami Paxton, LCSW Quality Youth Services 2240 North Hwy 89, Suite C, Harrisville, UT 84404 & 19 W Center #201, Logan UT 84321 Work: 801 38393-6232 Fax: 801 393-4081 Tami @qyservices.com Levels 1-4 Renew by: 02/18/2018 Richard Rawlins, LCSW Valley Mental Health 1141 Ea. 3900 So. #A-180 SLC, UT 84124 Work: 801-270-6527 Fax: 801-284-4989 rickr@vmh.com Levels 1, 2, & 3 Renew by: 11/21/2016 J.L. Redd, Ph.D., CMHC Solace Emotional Health 1364 W. State Street, Suite 204 Pleasant Grove, UT 84062 Work: 801-785-8885 office@SolaceEmotional.com Levels 1 & 2 Renew by: 08/15/2016 Linda J. Rhees, LCSW NeuroDynamix 2155 E 2100 S, Suite A, SLC, UT 84109 Work: 801 209-2005 Fax: 801 486-0197 Linda.neurodynamix.rhees@gmail.com Levels 1,2 Renew by: 09/18/2017 Greg Robinson Wasatch Mental Health 1161 East 300 North, Provo, UT 84058 Cell: 801 367-1420 Office: 801-852-4459 Fax: 801 375-4045 grobinson@wasatch.org Levels 1,2,3 Renew by: 09/19/2016 Jared Rockwood Birdseye RTC PO Box 117, Spanish Fork, UT 84660 Work: 801 873-3294 jaredrockwood@gmail.com Renew by: 05/16/2016 Reva Rosenband Youthtrack Utah 1755 N 200 E, North Logan UT 84341 Work: 435-753-6245, Ext 13 Reva.resenbanc@rescare.com Level 6 Renew by 5/18/2018 Stacy Scadden Weber Human Services 237 26th St., Ogden, UT 84401 Work: 801 625-3700 Fax: 801 778-6840 stacys@weberhs.org Levels 1,2 Renew by: 6/17/2017 Melanie Scarlet, LCSW Youth Health Associates 430 W 450 S, Clearfield UT Work 801-540-8054 Fax 801-774-9594 Melanie@yhautah.com Level 6 Renew by 2/20/2017 Todd Spaulding, LCSW Oxbow Academy 95 N. State HC 13 Box 4245 Wales, UT 84667 Work: 435-436-9460 Fax: 435-436-9466 todds@oxbowacademy.net Renew by: 06/28/2016 Phyllis Speciale, LCSW Abuse/Trauma Treatment 1141 Ea. 3900 So. A-1180 SLC, UT 84124 Work: 801-284-4988 Fax: 801-284-4989 phyllissp@valleycares.com Levels 1 & 2 Renew by: 09/19/2016 9 CREDENTIAL LIST-March 1, 2016 Clinical Provider Lauren Stivers Life Matters Counseling 740 E 3900 S, Murray UT 84115 Work 801-303-0555 Fax 801-313-9669 Lauren.stivers@gmail.com Levels 1,2,3 Renew by 2/20/2017 Gale Stringham, PhD Addiction and Psychological Services 224 No. Orem Blvd Orem, UT 84057 PO Box 51275, Provo, 84605-1275 Work: 801 222-0603 Fax: 801 222-0218 drgalebob@msn.com Renew by: 06/20/2016 Rashell Stubbs, CMHC Turning Point Family Care 121 No 1550 We Cedar City Work: 435 867-8168 Fax 435-867-5733 rashell@turningpointfamilycare.com Level 4, 6 Renew by: 03/19/2016 Mark Tiller, LCSW Youth Health Associates 13073 S. Wheatfield Way, Draper, UT 84020 Work: 801 913-8388 Fax: 801-774-9594 marktiller@msn.com Level 5 Renew by: 09/19/2016 Becky Valcarce, LPC Intermountain Specialized Abuse Treatment 1555 We 2200 So Suite A West Valley City, UT 84119 Phone: 801 886-8900 Fax: 801-886-8898 valcarbe@earthlink.net Levels 1,2 Evaluations Renew by: 08/15/2016 Mindy Vanderloo, CMHC Pinnacle Point Counseling, LLC 7069 S Highland Dr. #250Cottonwood Hghts, UT 84121 Work: 801-867-0462 Fax: Mindy.vanderloo@utah.edu Assessments Renew by: 02/20/2017 Doug “Tug” Wagstaff Chrysalis Enterprises, 1507 S 180 E, Provo UT 84606 Phone: 801 426-6661 Fax: 801 655-4954 Alpine Counseling, 415 W 50 N, American Fork, UT 84003 Phone: 801 756-3664 tugwag@gmail.com Renew by: 09/19/2016 David Walker Intermountain Specialized Abuse Treatment Center 1555 W 2200 S, Ste A, WVC UT 84119 Phone: 801-886-8900 Fax: 801-886-8898 dkwalkerisat@gmail.com Levels 1, 2 Renew by: 02/18/2019 Max Ward, LCSW Life Matters Counseling 740 E 3900 S #200, SLC UT 84107 Work: 801 313-0555 or 801-662-8169 Fax: 801-313-9669 Maxer03@gmail.com Levels 1,2,3 Renew by: 7/21/2016 Mace Warren, LCSW Alpha Counseling & Treatment 533 26th St, Ste 100, Rm 1, Ogden UT 84401 Work: 801 645-5455 Fax: 801-394-0394 macewarren@gmail.com Levels 1,2,3, 4 and SBRAs Renew by: 11/19/2018 Cara Webb, LCSW Mill Creek Youth Services 790 W 12th St., Ogden, UT 84404 Work: 801 334-0210 And Aloha Behavioral Consultants 707 24th St, Ste D, Ogden UT 84401 Phone 801-399-1818 bunniecaraot@aol.com Renew by: 09/18/2017 10 CREDENTIAL LIST-March 1, 2016 Clinical Provider Tiffany Winder, LCSW Oxbow Academy 95 State St, Wales UT 84647 W 435-436-9460 tiffanyw@oxbowacademy.net Level 6 Renew by 2/20/2016 Kirt Wise Youth Health Associates 387 Ea. 450 So. Clearfield, UT 84015 Work: 801 635-5022 Fax: 801-776-4162 and New Directions Counseling 31 W Center St, Kaysville UT 84037 Phone 801-660-5557 K2wise@juno.com Level 1,2,4,6 Renew by: 09/18/2017 Paul Woolf, PC Summit Community Counseling 5869 S Redwood Rd #27 Taylorsville, UT 84123 801 266-2485 paulw@summitcom.org Levels 2,3 Renew by: 07/12/2015 11 CREDENTIAL LIST-March 1, 2016 Affiliate Providers Sheri Allen Youthtrack-Utah 862 S Main Street #4, Brigham City 84302 Phone 435-723-1799 ext 203 Fax 435-723-2521 sheri.allen@rescare.com Levels 1,2,6 Renew by 7/25/2018 Robert Armstrong Alliance Clinical Services 71 N 490 S, American Fork UT 84003 Work 801-763-7775 Fax 801-763-7651 ACSutah@gmail.com Level 2 Renew by 4/16/2018 Celeste Anderson Intermountain Specialized Abuse Treatment Center 321 N Mall Drive #W104, St. George, UT 84790 Phone 435-628-8075 Fax 435-628-0252 Aceleste71@gmail.com Levels 1,2 Renew by 06/17/2017 Tyson Barlow Weber Human Services 237 26th Street, Ogden UT 84401 Phone 801-625-3684 fax 801-778-6840 tysonb@weberhs.org Level 2 Renew by 10/15/2018 Sharon Bingham Intermountain Specialized Abuse Treatment 189 S State St, Ste 160, Clearfield UT 84015 Phone 801 773-2044 Fax: 801 773-4826 clearfieldisat@gmail.com Levels 1,2 Renew by 2/20/2017 Steve Black Valley Behavioral Health – Children’s Outpatient 1141 E 3900 S, Salt Lake City UT 84106 Phone 801-284-4990 Fax: 801-284-4991 steveb@valleycares.com Levels 1 and 2 Renew by 5/21/2018 Stephanie Branson, MSW LDS Family Services-Riverton UT 84065 3740 Market Center Drive Suite #1200 Work: 1 801-240-9436 Fax: 1 801-240-9452 sbranson@ldsfamilyservices.org Levels 2,3 Renew by: 01/17/2016 Jeffrey Bright, LCSW Utah Youth Village Levels 2 & 3 5800 So. Highland Drive SLC, UT 84121 Work: 801-272-9980 Fax: 801-272-9976 jbright@youthvillage.org Levels 1-5 Renew by: 10/17/2016 Marnie Bushman Youthtrack-Utah 862 S Main Street #4, Brigham City UT 84302 Phone 435-730-3669 Fax 435-723-2521 Kmbushman5@yahoo.com Levels 1,2,6 Renew by 6/17/2017 Sharlene Christensen, LPC Landmark Family Counseling 9980 S 300 W #200, Sandy UT 84070 or 901 S Orem Blvd, Orem UT 84058 Work: 801-910-9558 Fax: 801-225-4946 sharutah@gmail.com Level 1,2 Renew by: 02/20/2017 Kjarsten Christensen Intermountain Specialized Abuse Treatment Center 1555 N 2200 S, Ste A, SLC UT 84119 Phone: 801-886-8900 Fax; 801-886-8898 kchristensenisat@gmail.com Levels 1,2 Renew by: 02-18-2019 12 CREDENTIAL LIST-March 1, 2016 Affiliate Providers McKenzie Combe Intermountain Specialized Abuse Treatment Center 1868 North 1120 West, Provo UT 84604 Phone 801-373-0210 Fax 801-373-0215 ladamsisat@hotmail.com Levels 1,2 Renew by 6/17/2017 John Greg Cowan Gray Matters Counseling 23 S Carbon Ave #5, Price UT 84501 Phone 435-650-9008 Fax 435-637-5195 gregclea@hotmail.com Levels 1,2,3 Renew by 9/18/2017 Roselene Dalanhese South Point Counseling Services 1206 South Jordan Pkwy Ste D, South Jordan 84095 roselene@southpointcs.com Assessments, 1,2 Renew by 7/16/18 Jeffrey Duncan Intermountan Specialized Abuse Treatment Center 321 N Mall Drive, Ste VN104, St George UT 84790 Phone 435-628-8075 Fax 435-628-0252 isat@skyviewtech.com Levels 1,2 Renew by 5/21/2018 Timothy Fidler Youth Health Associates 501 W 2600 S #200, Bountiful UT 84010 Phone 801-910-7344 Timfidler550@gmail.com Levels 1/2/4/6 Renew by 10/15/2018 Jennifer German Intermountain Specialized Abuse Treatment 1555 W 2200 S, #A, WVC 84119 Phone 801-886-8900 Fax 801-886-8898 jgermanisat@gmail.com Levels 1,2 Renew by 7/16/2018 Erin Cotten, LCSW Behavioral Mental Health Services 40 W. Cache Valley Blvd. Suite 10-A Logan 84341 Phone: 435 787-2272 Fax: 435 713-4001 erincotten@addictions-healing.com Renew by: 01/17/2016 Annette Curtis Utah Youth Village 5800 S Highland Dr. SLC UT 84121 Work: 801-272-9980 or 801-308-1062 Fax 801-272-9976 acurtis@youthvillage.org Levels 4&5 Renew by: 2/20/2017 David Daroff Apex Behavioral Health 5129 S 1500 W, Riverdale UT 84405 Work: 801-621-4490 apexbehavioralhealth@gmail.com Renew by: 06/20/2016 Zachary Duvall LDS Family Services 3740 West Market Center Dr., #1200 Riverton UT 84065 Phone 801-240-9436 Fax 801-240-3150 zachary.duvall@ldsfamilyservices.org SBRA’s, Levels 1,2 Renew by: 10/16/2017 Robert Fairbanks Heritage Youth Services 31 E 1600 N, Spanish Fork UT 84664 Work: 801-978-9077 Fax: 801-798-8949 dan@birdseyertc.com Level 5/6 Renew by: 02/29/2018 Angela Hickok Gerritsen Intermountain Specialized Abuse Treatment Center 1868 N 1120 W, Provo UT 84604 Work: 801-373-0210 Fax: 801-373-0215 provoisat@gmail.com Levels 1,2 Renew by 11/21/16 13 CREDENTIAL LIST-March 1, 2016 Affiliate Providers Marcelle Guglielmetti Intermountain Specialized Abuse Treatment 1555 W 2200 S #A, WVC, UT 84119 Phone 801-886-8900 Fax 801-886-8898 mguglielmetti@utah.gov Levels 1,2 Renew by 9/9/2016 Jesse Heaton Utah Youth Village 5800 S Highland Dr., Holladay UT 84121 Work 801-541-2271 Fax 801-272-9976 jheaton@youthvillage.org Levels 1-5 Renew by: 2/20/2017 Ivysue Hranac Aloha Behavioral Consultants, Inc 707 24th St, Ste D, Ogden UT 84401 Phone 801-399-1818 Cell 801-866-2388 Fax 801-782-8412 Levels 1,2,3 Renew by 6/17/ 2017 Scott Innes LDS Family Services 3740 W Market Center Dr. Ste 1200, Riverton 84065 Phone 801-240-9436 Scott.innes@ldsfamilyservices.net Levels 1/2/3 Renew by 10/26/2018 Abbie Jensen Utah Youth Village 5800 S Highland Drive, SLC UT 84121 Work: 801 633-5665 Fax: 802-272-9976 ajensen@youthvillage.org Levels 1,2 Renew by 11/21/2016 Regina Gulick Aspen Ridge Counseling 2880 W 4700 S, Ste G-1 West Valley City UT 84129 Phone 801-990-4300 Aspenridge.regina@gmail.com 1,2,3 Renew by 6/17/2017 Guadalupe Hernandez LDS Family Services-Riverton 3740 We Market Center Dr. Work: 801 240-9436 Fax: 801 240-9452 hernandezl@ldsfamilyserfvices.org Levels 1,2 Renew by: 3/19/2016 Julie Ann Higgs, CMHC Weber Human Services 237 26th Str., Ogden, UT 84401 Work: 801 625-3700 Fax: 801 778-6840 jhiggs@weberhs.org Renew by: 06/20/2016 Leah Huhnke Summit Community Counseling 5689 S Redwood Rd, Taylorsville UT Phone 801-608-8067 leahkhuhnke@gmail.com Levels 1,2 Renew by: 10/17/2016 Trevor Irish Harris Counseling and Consulting Services 38 W 100 N, Vernal UT 84078 Phone 435-219-6312 Trevor.hccs@gmail.com Levels 4/5 Renew by 7/18/2018 Jenny Johnson Alliance Clinical Services 71 No 490 We. American Fork, UT 84003 Work: 801 763-7775 Fax: 801 763-7651 acsutah@gmail.com Renew by: 03/19/2016 14 CREDENTIAL LIST-March 1, 2016 Affiliate Providers Nicki Kasteler Valley Behavioral Health 1141 E 3900 S, Salt Lake City UT 84106 Work: 801-284-4990 Fax: 801-284-4991 nickik@valleycares.com Levels 1 and 2 Renew by 5/18/2018 Britten Lamb, CSW Weber Human Services 237 26th St., Ogden, UT 84401 Work: 801 625-3700 Fax: 801 778-6840 brittenl@weberhs.org Levels 1,2 Renew by: 02/27/2015 Gwen Laws Alliance Clinical Services 71 No. 490 We. American Fork, UT 84003 Work: 801 763-7775 Fax: 801 763-7651 acsutah@gmail.com Levels 1,2,6 Renew by: 2/18/2019 Tyler Money, PhD Utah Psychological Services 1453 N 1200 W, Orem UT 84057 Work: 801 734-4945 Fax: 801-734-4946 drtylermoney@gmail.com Renew by: 03/19/2016 Sandra Larson LDS Family Services 3740 W Market Center Dr. Ste 1200 Riverton UT 84065 Work: 801-240-9436 sandralarson@ldsfamilyservices.org Levels 1,2 Renew by: 2/19/2018 Gary Michaels, CMHC Jordan West Family Counseling 9263 S Redwood Rd, Bld 8 Ste B West Jordan 84088 Phone 801-566-0749 Fax 801-566-7108 Gary.michaels@yahoo.com Levels 1-2 Renew by 06/17/2017 Kristin Orgill Millcreek Youth Center (JJS) 790 W 12th S, Ogden UT 84401 Work: 801-334-0210 korgill@utah.gov Level 8 Renew by: 02/19/2018 Analee Pacheco Comprehensive Treatment Clinic 40 W Cache Valley Blvd #10A, Logan UT 84341 Phone 801-725-9446 analeepacheco@gmail.com Levels 1-4 Renew by: 09/15/2018 Krista Petersen Center for Family Evaluation and Treatment 5691 S Redwood Rd #15, Taylorsville UT 84123 Work 801-265-3895 Fax 801-263-1265 cfetutah@gmail.com Levels 1,2,3 Renew by 4/16/18 Amanda Pfeffer, PhD Center for Family Evaluation and Treatment 5691 So. Redwood Road SLC UT. 84123 Work: 1 801-265-3895 Fax: 1 801-263-1265 Cfet.officemanager@yahoo.com Levels 1,2 Evals Renew by: 01/17/2016 15 CREDENTIAL LIST-March 1, 2016 Affiliate Providers Kael Pope Intermountain Specialized Abuse Tx Ctr 1555 W 2200 S, Ste. A, SLC 84165 Work: 801-886-8900 Fax: 801-886-8898 slcisat@gmail.com Levels 1,2 Renew by: 11/21/2016 Moniemarie Riddle Youth Health Associates 501 W 2600 S, Bountiful UT 84010 Work: 801 864-5629 mriddle@yhautah.com Levels 4,6 Renew by: 01/17/2016 Ryan Sadeghi Youth Health Associates 430 E 450 S, Clearfield UT 84015 Work: 801-776-3305 Fax: 801-683-8962 Ryansadeghi25@yahoo.com Level 5 Renew by 6/17/2018 Julia Simpson Utah Psychological Services 1453 N 1200 W, Orem UT 84057 Phone 801-734-4945 drjuliasimpson@gmail.com Level 1,2, Evals Renew by 07/16/2018 Bernadette Smith Stepping Stones/A/D Psychotherapy 1363 S State St #140, SLC UT 84115 Phone 801-809-3751 Fax 801-493-2013 Bsmith2240@yahoo.com Levels 1,2 Renew by 10/15/2018 Robyn Thorsted Youthtrack-Utah 862 S Main St #4, Brigham City UT 84302 Phone 435-230-4775 Fax 435-723-2521 Robyn.thorsted@rescare.com Levels 1,2,6 Renew by 6/17/2017 John Heath Selin New Directions Counseling Service 31 W Center St, Kaysville UT 84037 Work 801-660-5557 Fax 801-734-8433 newdirections@ymail.com Levels 1,2 Renew by 2/20/2017 Steven Bradley Ward Youthtrack-Utah 862 S Main St #4, Brigham City UT 84302 Phone 435-753-6245 Fax 435-787-9320 Brad.ward@rescare.com Level 6 Renew by: 6/17/2017 Alison Wheatley Valley Behavioral Health 1141 E 3900 S Ste A-170, SLC UT 84124 Phone 801-284-4990 Fax 801-284-4991 alisonwh@valleycares.com Levels 1,2 Renew by 9/15/2018 Michael Thompson Alliance Youth Services 71 N 490 W, American Fork 84003 Phone 801-763-7775 acsutah@gmail.com Levels 1-6 Renew by 2/18/2019 Aaron Tveter Come About Youth Services 856 S. Main Street, Pleasant Grove UT 94602 Work: 801-899-2076 tveteraaron@hotmail.com Level 2 Renew by: 06/20/2016 16 CREDENTIAL LIST-March 1, 2016 Affiliate Providers Chad Winters Youth Health Associates 6484 N 2300 W, Cedar City UT 84721 Work 435-590-6993 Fax 435-867-4893 cwintersyha@yahoo.com Renew by: 02/20/2017 Jennifer Wright Youth Health Associates 430 E 450 S, Clearfield, UT 84015 Phone 801-390-9447 Fax 801-525-6415 Wrightjennifer416@gmail.com Level 6 Renew by: 9/18/2017 17
