Healthcare Provider Details

I. General information

NPI: 1801549050
Provider Name (Legal Business Name): SAM AND RAGAN LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2022
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E CENTER ST STE 300
PROVO UT
84606-3154
US

IV. Provider business mailing address

1356 S 2770 E
SPANISH FORK UT
84660-9403
US

V. Phone/Fax

Practice location:
  • Phone: 801-332-9660
  • Fax:
Mailing address:
  • Phone: 801-228-0606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. SAMUEL RYLAND
Title or Position: PARTNER
Credential: LCSW
Phone: 801-228-0606