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GREAT SALT LAKE WELLNESS INC NPI 1790152940


NPI Information

NPI: 1790152940
Provider Name: GREAT SALT LAKE WELLNESS INC
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
375 N MAIN ST STE 202
KAYSVILLE, UT
ZIP 84037
Phone: (801) 844-1615
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GREAT SALT LAKE WELLNESS INC is a clinical psychologist in Kaysville, UT. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. GREAT SALT LAKE WELLNESS INC NPI is 1790152940. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

375 N MAIN ST STE 202
KAYSVILLE, UT
ZIP 84037-278
Phone: (801) 844-1615
Fax: (801) 825-1162

The provider's authorized official is Emily Young Bullock .
The authorized official title is Owner and has the following contact phone number (801) 389-9521.

The enumeration date for this NPI number is 8/24/2015 and was last updated on 4/17/2024.


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
1103TC0700XPsychologistClinical7510289-2501UTAHYes

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.