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General NPI Number Information
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NPI Number | 1295792117
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Entity Type | Organization
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Legal Business Name | VALLEY MENTAL HEALTH INCORPORATED
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 03/13/2012
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Provider Practice Location Address
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Address Line | 4460 HIGHLAND DR SUITE 300
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City | SALT LAKE CITY
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State | UT
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Zip | 84124-3543
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Country | US
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Telephone | 801-273-6366
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Fax | 801-273-6363
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Provider Business Mailing Address
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Address Line | 5965 S 900 E SUITE 420
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City | SALT LAKE CITY
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State | UT
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Zip | 84121-1720
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Country | US
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Telephone | 801-263-7100
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Fax | 801-263-7123
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MS. GARY LARCENAIRE
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Credential |
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Telephone | 801-263-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | UT
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Taxonomy #5
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number |
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License Number State | UT
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Taxonomy #6
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State | UT
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