Individual provider Active NPI

Paul Scott Flack, DMFT, LMFT

  • Marriage & Family Therapist
  • Woods Cross, UT
National Provider Identifier
1124234349
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
5276452-3902 Issued in UT
Practice address
512 W 750 S Ste a
Woods Cross, UT 84010-7221
Phone
(801) 935-8449
NPI assigned
May 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 5276452-3902 UT Primary

Addresses

Primary practice location

512 W 750 S Ste a
Woods Cross, UT 84010-7221

Mailing address

512 W 750 S Ste a
Woods Cross, UT 84010-7221
Phone (801) 486-4877

Other identifiers 1

IdentifierTypeStateIssuer
1124234349MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251219003377 UT Practitioner - Marriage and Family Therapist 1153816707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3855 S 500
Suite E
South Salt Lake, UT 84115-4253

PO Box
Suite 167
Kaysville, UT 84037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5276452-3902UTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sol Recovery Community, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Sol Recovery Community, Inc. CurrentSince Feb 2, 2025 Accepting new patients

Locations

3855 S 500 W
Ste E
South Salt Lake, UT 84115
Phone (801) 590-7999

512 W 750 S
Ste A
Woods Cross, UT 84010
Phone (801) 935-8449

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1124234349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 W 750 S STE A",
            "city": "WOODS CROSS",
            "state": "UT",
            "postal_code": "840107221",
            "telephone_number": "801-486-4877",
            "fax_number": "801-214-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 W 750 S STE A",
            "city": "WOODS CROSS",
            "state": "UT",
            "postal_code": "840107221",
            "telephone_number": "801-935-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLACK",
        "first_name": "PAUL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DMFT, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2025-06-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "5276452-3902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124234349",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woods Cross, UT

Sources for this page

Verify at the official NPI Registry.