Healthcare Provider Details

I. General information

NPI: 1043134836
Provider Name (Legal Business Name): GODFREY ADVANCED PSYCHOLOGICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 N 400 E STE 108
NORTH SALT LAKE UT
84054-1984
US

IV. Provider business mailing address

940 N 400 E STE 108
NORTH SALT LAKE UT
84054-1984
US

V. Phone/Fax

Practice location:
  • Phone: 801-332-9414
  • Fax:
Mailing address:
  • Phone: 801-332-9414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. DONALD ANDREW GODFREY
Title or Position: LICENSED PSYCHOLOGIST
Credential: PHD
Phone: 801-332-9414