Synergism Counseling, LLC

Key facts

NPI

1124313481

Entity type

Organization (NPI type 2)

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Legal business name

SYNERGISM COUNSELING, LLC

Practice address

11075 S State St Ste 16
Sandy, UT 84070-5196

Phone

(801) 350-1671

Fax

(801) 446-6511

NPI assigned

Jun 15, 2011

Organization subpart

No

Authorized official

Name

Mrs. Michelle H Greene, LCSW NPI 1508971276

Title

Owner/Therapist

Phone

(801) 350-1671

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle H Greene, LCSW Clinical Social Worker · Sandy, UT · NPI 1508971276
  Medicare reassignment NPD Authorized official UT
• Christine McLaws, AMFT Mental Health Counselor · Heber City, UT · NPI 1689296352
  NPD
• Matthew Foutz, LCSW Clinical Social Worker · Sandy, UT · NPI 1982403978
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in UT

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 11, 2018.

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536624000000",
    "number": "1124313481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1292",
            "city": "MIDWAY",
            "state": "UT",
            "postal_code": "840491292",
            "telephone_number": "801-350-1671",
            "fax_number": "801-446-6511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11075 S STATE ST STE 16",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840705196",
            "telephone_number": "801-350-1671",
            "fax_number": "801-446-6511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 E 1200 S Ste L4",
            "address_purpose": "LOCATION",
            "city": "Heber City",
            "state": "UT",
            "postal_code": "840323943",
            "country_code": "US",
            "telephone_number": "435-962-9335",
            "fax_number": "801-446-6511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SYNERGISM COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-15",
        "last_updated": "2018-09-11",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "801-350-1671",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Sandy, UT · Mental Health Clinic/Center (Including Community Mental Health Center) in Utah