MEDICARE: ALBION ASSESMENT & PSYCHOTHERAPY ASSOCIATES

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
1	103TC2200X	Clinical Child & Adolescent Psychologist	1157832501	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922145507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALBION ASSESMENT & PSYCHOTHERAPY ASSOCIATES

Provider Business Mailing Address
First Line	:	555 E 4500 S
Second Line	:	SUITE C-150
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84107-4533
Country	:	US
Telephone Number	:	801-288-0747
Fax Number	:	801-288-0761

Provider Business Practice Location Address
First Line	:	1414 E 4500 S
Second Line	:	#4A
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-4228
Country	:	US
Telephone Number	:	801-274-6700
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. PATRICIA K HOPPS
Credential	:	PH.D
Telephone Number	:	801-274-6700

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	08/22/2020

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