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NPI Code Detail

MEDICARE: VALLEY MENTAL HEALTH INCORPORATED

MEDICARE: VALLEY MENTAL HEALTH INCORPORATED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2104100000XSocial Worker
31041C0700XClinical Social Worker

General Provider Information

NPI Number : 1841486016
Entity Type Code : Organization
Provider Name (Legal Business Name) : VALLEY MENTAL HEALTH INCORPORATED
Provider Business Mailing Address
First Line : 5965 S 900 E
Second Line : SUITE 420
City : SALT LAKE CITY
State : UT
Zip : 84121-1720
Country : US
Telephone Number : 801-263-7100
Fax Number : 801-263-7123
Provider Business Practice Location Address
First Line : 1724 S MAIN ST
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84115-1912
Country : US
Telephone Number : 801-486-5012
Fax Number : 801-466-5077
Authorized Official
Title or Position : CEO/PRESIDENT
Name : DEBRA L FALVO
Credential : MHSA/RNC
Telephone Number : 801-263-7100
Provider Enumeration Date : 09/20/2007
Last Update Date : 08/26/2011

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Directions to “VALLEY MENTAL HEALTH INCORPORATED ” Practice Location

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