Mary Jann Dewitt LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

308921-2501 Issued in UT

Legal business name

MARY JANN DEWITT LLC

Practice address

1104 E Ashton Ave Ste 108
Salt Lake City, UT 84106-2348

Phone

(801) 510-4547

NPI assigned

Oct 23, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary Jann Dewitt, PHD

Title

Clinical Psychologist

Phone

(801) 510-4547

Specialties & licenses 1

Addresses

Other names 1

• Jann DeWitt LLC Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583020800000",
    "number": "1083125694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 E ASHTON AVE STE 108",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062348",
            "telephone_number": "801-510-4547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 E ASHTON AVE STE 108",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062348",
            "telephone_number": "801-510-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY JANN DEWITT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-23",
        "last_updated": "2020-03-01",
        "certification_date": "2020-03-01",
        "status": "A",
        "authorized_official_last_name": "DEWITT",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JANN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "801-510-4547",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "308921-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jann DeWitt LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Mary Jane Norman MD a Professional Corporation
• Mary K. Beard MD
• Mary M Martineau LCSW LLC
• Mary M. Martineau
• Marybeth Raynes L.C.S.W., PC
• Elizabeth Defriez Maryon, CMHC STUDENT

• Clinical Psychologist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Clinical Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.