Healthcare Provider Details

I. General information

NPI: 1811834641
Provider Name (Legal Business Name): MOMENTUM PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1556 S STAR SPRINGS DR
WASHINGTON UT
84780-3636
US

IV. Provider business mailing address

1556 S STAR SPRINGS DR
WASHINGTON UT
84780-3636
US

V. Phone/Fax

Practice location:
  • Phone: 480-290-2267
  • Fax:
Mailing address:
  • Phone: 480-290-2267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW ANDRUS
Title or Position: PMHNP
Credential:
Phone: 435-986-9369