LIFE TREE PLLC NPI 1982135265

NPI Information

NPI: 1982135265
Provider Name: LIFE TREE PLLC

Doing Business As: LIFE TREE PSYCHIATRY

Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
251 W STATE ROAD 198 STE 3
SALEM, UT
ZIP 84653
Phone: (801) 504-6665
Get Directions

LIFE TREE PLLC is a psychiatric/mental health nurse practitioner in Salem, UT. LIFE TREE PLLC NPI is 1982135265. The provider is registered as an organization entity type.
The provider Is Doing Business As Life Tree Psychiatry.

The provider's business location address is:

251 W STATE ROAD 198 STE 3
SALEM, UT
ZIP 84653-608
Phone: (801) 504-6665
Fax: (801) 504-9073

The provider's authorized official is Josh Hooton .
The authorized official title is Owner/provider and has the following contact phone number (805) 504-6665.

The CLIA number assigned to this NPI record is 46D2134474 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/27/2017 and was last updated on 10/21/2019.

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	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			No
2	261QM1300X	Clinic/Center	Multi-Specialty			No
3	261QP2300X	Clinic/Center	Primary Care	6227164-4405	UTAH	No
4	363LA2200X	Nurse Practitioner	Adult Health			No
5	363LF0000X	Nurse Practitioner	Family			No
6	363LG0600X	Nurse Practitioner	Gerontology			No
7	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			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	2019033956	OTHER		ANCC PMHNP BOARD CERTIFICATION

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

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.

« Previous NPI

Next NPI »