I PROMISE FOUNDATION NPI 1144594003

NPI Information

NPI: 1144594003
Provider Name: I PROMISE FOUNDATION
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
3521 N UNIVERSITY AVE
SUITE 225
PROVO, UT
ZIP 84604
Phone: (801) 472-9780
Get Directions

I PROMISE FOUNDATION is an addiction (substance use disorder) counselor in Provo, UT. I PROMISE FOUNDATION NPI is 1144594003. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

3521 N UNIVERSITY AVE
SUITE 225
PROVO, UT
ZIP 84604-418
Phone: (801) 472-9780
Fax: (801) 426-4615

The provider's authorized official is Kendra Bernal .
The authorized official title is Executive Director and has the following contact phone number (801) 472-9780.

The enumeration date for this NPI number is 2/23/2012 and was last updated on 2/23/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TC1900X	Psychologist	Counseling	19034	UTAH	No
2	101YM0800X	Counselor	Mental Health	19034	UTAH	No
3	101YP1600X	Counselor	Pastoral	19034	UTAH	No
4	101YP2500X	Counselor	Professional	19034	UTAH	No
5	101YS0200X	Counselor	School	19034	UTAH	No
6	102L00000X	Psychoanalyst		19034	UTAH	No
7	103TA0400X	Psychologist	Addiction (Substance Use Disorder)	19034	UTAH	No
8	103TB0200X	Psychologist	Cognitive & Behavioral	19034	UTAH	No
9	103TP0016X	Psychologist	Prescribing (Medical)	19034	UTAH	No
10	103TP2701X	Psychologist	Group Psychotherapy	19034	UTAH	No
11	1041C0700X	Social Worker	Clinical	19034	UTAH	No
12	106H00000X	Marriage & Family Therapist		19034	UTAH	No
13	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	19034	UTAH	No
14	261QM0850X	Clinic/Center	Adult Mental Health	19034	UTAH	No
15	101YA0400X	Counselor	Addiction (Substance Use Disorder)	19034	UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	19034	OTHER	UTAH	STATE OF UTAH - HEALTH & HUMAN SERVICES LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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