Provider Type Icon

SOUTH DAVIS PSYCHOLOGICAL SERVICES NPI 1386142396


NPI Information

NPI: 1386142396
Provider Name: SOUTH DAVIS PSYCHOLOGICAL SERVICES
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
520 N MARKET PLACE DR STE 200
CENTERVILLE, UT
ZIP 84014
Phone: (801) 934-3373
Get Directions

SOUTH DAVIS PSYCHOLOGICAL SERVICES is a mental health (including community mental health center) clinic center in Centerville, UT. SOUTH DAVIS PSYCHOLOGICAL SERVICES NPI is 1386142396. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

520 N MARKET PLACE DR STE 200
CENTERVILLE, UT
ZIP 84014-904
Phone: (801) 934-3373

The provider's authorized official is Jonathan Ahern .
The authorized official title is Owner and has the following contact phone number (801) 934-3373.

The enumeration date for this NPI number is 1/24/2018 and was last updated on 9/7/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinicalNo
2261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11437400447MEDICAIDUTAH

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.