MEDICARE: KAY PSYCHOLOGICAL AND CONSULTING SERVICES

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
1	103TC0700X	Clinical Psychologist	376632-2501	UT

General Provider Information

NPI Number	:	1619077161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAY PSYCHOLOGICAL AND CONSULTING SERVICES

Provider Business Mailing Address
First Line	:	880 HERITAGE PARK BLVD STE 230C
Second Line	:
City	:	LAYTON
State	:	UT
Zip	:	84041-5676
Country	:	US
Telephone Number	:	801-776-1303
Fax Number	:	801-416-0793

Provider Business Practice Location Address
First Line	:	880 HERITAGE PARK BLVD STE 230C
Second Line	:
City	:	LAYTON
State	:	UT
Zip	:	84041-5676
Country	:	US
Telephone Number	:	801-776-1303
Fax Number	:	801-416-0793

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEVEN JAMES KAY
Credential	:	PSY.D.
Telephone Number	:	801-776-1303

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	04/20/2008

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