Mind, Body, Soul Utah

Primary specialty

Social WorkerTaxonomy code 104100000X

License

86376063502 Issued in UT

Legal business name

MIND, BODY, SOUL UTAH

Practice address

699 E South Temple Ste 145
Salt Lake City, UT 84102-4200

Phone

(801) 906-8780

NPI assigned

Jul 15, 2015

Organization subpart

No

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

Authorized official

Name

Chuck Nuttall

Title

LCSW

Phone

(801) 906-8780

Specialties & licenses 1

Addresses

Tax ID family

Mind Body Soul Utah2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mind, Body, Soul, Utah

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Salt Lake City, UT
  • NPI 1407169907
  NPD tax ID

Locations

Practitioners 1

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

• Mariah Rist

  • Social Worker
  • Salt Lake City, UT
  • NPI 1114303153
  NPD (past)

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436918400000",
    "number": "1295119600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 E SOUTH TEMPLE STE 145",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841024200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 E SOUTH TEMPLE STE 145",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841024200",
            "telephone_number": "801-906-8780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND, BODY, SOUL UTAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-15",
        "last_updated": "2015-07-15",
        "status": "A",
        "authorized_official_last_name": "NUTTALL",
        "authorized_official_first_name": "CHUCK",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "801-906-8780"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "UT",
            "license": "86376063502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wonhong David Min, MD
• Mary Ann Elizabeth Mincy
• Mind Set Meds LLC
• Mind Stretch Psychology PLLC
• Mind, Body & Spirit Counseling LLC
• Mind, Body, Soul, Utah
• Camille Michael Minder, M.D.
• Mindful Healing LLC
• Mindful Infusions
• Mindfully Rooted

• Social Worker in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.