Active NPI
Matthew Davis, PH.D.
- Counseling Psychologist
- SLC, UT
National Provider Identifier
1174973531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 295319-2504
- Practice address
- 501 S Chipeta Way
SLC, UT 84108-1222 - Phone
- (801) 583-2500
- NPI assigned
- Jun 16, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 295319-2504 | UT | Primary |
Addresses
Primary practice location
501 S Chipeta Way
SLC, UT 84108-1222
Mailing address
501 S Chipeta Way
SLC, UT 84108-1222
Phone (801) 583-2500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 295319-2504 | UT | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466035200000",
"number": "1174973531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 S CHIPETA WAY",
"city": "SLC",
"state": "UT",
"postal_code": "841081222",
"telephone_number": "801-583-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S CHIPETA WAY",
"city": "SLC",
"state": "UT",
"postal_code": "841081222",
"telephone_number": "801-583-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MATTHEW",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-16",
"last_updated": "2016-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "UT",
"license": "295319-2504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in SLC, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.