Healthcare Provider Details

I. General information

NPI: 1396699104
Provider Name (Legal Business Name): REVOLUTIONS THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1452 E 820 N
OREM UT
84097-5481
US

IV. Provider business mailing address

PO BOX 835
PLEASANT GROVE UT
84062-0835
US

V. Phone/Fax

Practice location:
  • Phone: 801-432-0822
  • Fax:
Mailing address:
  • Phone: 801-432-0822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER WILLIAM MATTESON
Title or Position: OWNER
Credential: MS, LMFT
Phone: 801-432-0822