Healthcare Provider Details

I. General information

NPI: 1083547467
Provider Name (Legal Business Name): HEARTWOOD FAMILY THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1054 E HAMMOCK LN
SARATOGA SPRINGS UT
84045-5676
US

IV. Provider business mailing address

1054 E HAMMOCK LN
SARATOGA SPRINGS UT
84045-5676
US

V. Phone/Fax

Practice location:
  • Phone: 801-717-9182
  • Fax:
Mailing address:
  • Phone: 801-717-9182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER GRIFFITH PETERSON
Title or Position: OWNER
Credential: MFT
Phone: 801-717-9182