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NPI Code Detail

MEDICARE: VALLEY MENTAL HEALTH INCORPORATED

MEDICARE: VALLEY MENTAL HEALTH INCORPORATED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorUT
2106H00000XMarriage & Family TherapistUT
3163WP0807XChild & Adolescent Psychiatric/Mental Health Registered NurseUT
4103TC0700XClinical PsychologistUT
51041C0700XClinical Social WorkerUT
62355S0801XSpeech-Language AssistantUT
7363LP0808XPsychiatric/Mental Health Nurse PractitionerUT
82084P0804XChild & Adolescent Psychiatry PhysicianUT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12423OTHERUTPEHP

General Provider Information

NPI Number : 1154387678
Entity Type Code : Organization
Provider Name (Legal Business Name) : VALLEY MENTAL HEALTH INCORPORATED
Provider Business Mailing Address
First Line : PO BOX 572070
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84157-2070
Country : US
Telephone Number : 801-263-7100
Fax Number : 801-263-7123
Provider Business Practice Location Address
First Line : 780 GUARDSMAN WAY
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-1374
Country : US
Telephone Number : 801-581-0194
Fax Number :
Authorized Official
Title or Position : PRESIDENT & CEO
Name : JARED SANFORD
Credential :
Telephone Number : 360-949-9588
Provider Enumeration Date : 04/24/2006
Last Update Date : 12/19/2024

Similar Medicare Providers

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Practice Location Address:
780 S GUARDSMAN WAY
SALT LAKE CITY, UT
84108-1374
Practice Phone: 888-949-4864
Practice Fax:
1154306421 — MR. DOUGLAS BOWEN BRUNKER LCSW
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Practice Fax: 801-581-0193
1437138807 — MRS. MARIN C BYWATER LCSW
Practice Location Address:
780 GUARDSMAN WAY
SALT LAKE CITY, UT
84108-1374
Practice Phone: 801-581-0194
Practice Fax: 801-581-0193
1346229713 — MRS. ANNA MARIE ROUMPOS LCSW
Practice Location Address:
780 GUARDSMAN WAY
SALT LAKE CITY, UT
84108-1374
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Practice Fax: 801-581-0193
1588643852 — DR. PETER MICHAEL NICHOLAS LCSW
Practice Location Address:
780 GUARDSMAN WAY
SALT LAKE CITY, UT
84108-1374
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Practice Fax: 801-581-0193
1255311056 — MS. SUSAN LYN PIZITZ LCSW
Practice Location Address:
780 GUARDSMAN WAY
SALT LAKE CITY, UT
84108-1374
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Practice Fax: 801-581-0193
1861472177 — KIMBERLY MITCHELL LCSW
Practice Location Address:
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84108-1374
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Practice Fax: 801-581-0193

Directions to “VALLEY MENTAL HEALTH INCORPORATED ” Practice Location

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