Organization Active NPI

Universal Health Systems

  • Mental Health Counselor
  • Provo, UT
National Provider Identifier
1255974085
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
UNIVERSAL HEALTH SYSTEMS
Practice address
4501 N University Ave
Provo, UT 84604-5504
Phone
(801) 932-6364
NPI assigned
Oct 24, 2019
Organization subpart
Yes
Parent organization
PROVO CANYON SCHOOLAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Authorized official

Name
Max Ah Quin, CMHC
Title
Clinical Director
Phone
(801) 932-2544

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Mental Illness Community Based Residential Treatment Facility 320800000X

Addresses

Primary practice location

4501 N University Ave
Provo, UT 84604-5504

Mailing address

4501 N University Ave
Provo, UT 84604-5504
Phone (801) 932-2532

Other names 1

  • Provo Canyon School Other name

National Provider Directory

National Provider Directory
Part of
Universal Health Systems

Locations

4501 N University Ave
Provo, UT 84604
Phone (801) 227-2000

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571875200000",
    "number": "1255974085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 N UNIVERSITY AVE",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846045504",
            "telephone_number": "801-932-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 N UNIVERSITY AVE",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846045504",
            "telephone_number": "801-932-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL HEALTH SYSTEMS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVO CANYON SCHOOL",
        "enumeration_date": "2019-10-24",
        "last_updated": "2019-10-24",
        "status": "A",
        "authorized_official_last_name": "AH QUIN",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "801-932-2544",
        "authorized_official_credential": "CMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Provo Canyon School",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Provo Canyon School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.