Valley Mental Health Incorporated
Organization Active NPI Psychiatry Physician · Salt Lake City, UT
NPI 1124085170 · NPPES record last updated Aug 25, 2011
Key facts
- NPI
- 1124085170
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- VALLEY MENTAL HEALTH INCORPORATED
- Practice address
- 1141 E 3900 S
Suite A170
Salt Lake City, UT 84124-1215 - Phone
- (801) 284-4990
- Fax
- (801) 284-4991
- NPI assigned
- Apr 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Debra Falvo, MHCA/RN
- Title
- Executive Director
- Phone
- (801) 253-7100
Other NPIs on the same Medicare enrollment 20
Practitioners 26
-
C. Leroy Anderson, M.D.
-
Jared Andes, CSW
-
Whitney Jane Barrell, LCSW
-
Jean C Bramble, APRN
-
Edwin R Christensen, PHD
-
Michele R Decremer, LCSW
-
Marvin Goldstein, LCSW
-
Lisa Ann Gustavson, PH.D.
-
Jamal S Hejazi, MD
-
Ashley Jan Henderson, LCSW
-
Kenneth John Hopps, PH.D.
-
Elaine D. Jewett, C.S.W.
-
Ralph William Knapp, M.D.
-
Mary June Latu, LCSW
-
Tylean Ann McTurk, LCSW
-
Maria Christina Paegle, APRN
-
Karen Lee Platis, LCSW
-
Janet Madeleine Pohanka, LCSW
-
Cory Melvin Shipp, LCSW
-
Phyllis Speciale, LCSW
-
Sandra Kay Varley, LCSW
-
Trinity L Vercimak, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031111000937 | UT | Part B Supplier - Clinic/Group Practice | 0042121196 |
Receives reassigned benefits from 129 practitioners 20 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | UT | ||
| Clinical Psychologist |
103TC0700X | UT | ||
| Social Worker |
104100000X | UT | ||
| Clinical Social Worker |
1041C0700X | UT | ||
| Marriage & Family Therapist |
106H00000X | UT | ||
| Psychiatric/Mental Health Registered Nurse |
163WP0808X | UT | ||
| Psychiatry Physician |
2084P0800X | UT | Yes | |
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | UT |
Addresses
Primary practice location
1141 E 3900 S
Suite A170
Salt Lake City, UT 84124-1215
Mailing address
5965 S 900 E
Suite 240
Salt Lake City, UT 84121-1720
Phone (801) 263-7100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2423 | Other | UT | PEHP |
Other names
- CHILDREN'S OUTPATIENT SERVICES
Other providers in Salt Lake City, UT
- Jacqueline Dailey Valles
- Valley Mental Health
- Valley Mental Health
- Valley Mental Health Incorporated
- Valley Mental Health Incorporated
- Valley Mental Health Incorporated
- Valley Mental Health Incorporated
- Valley Mental Health Incorporated
- Valley Mental Health Incorporated
- Valley Mental Health Incorporated
All providers in Salt Lake City, UT · Psychiatry Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.