Organization Active NPI

Paz Wellness

  • Mental Health Counselor
  • Providence, UT
National Provider Identifier
1306619044
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
PAZ WELLNESS
Practice address
169 N Gateway Dr # 110
Providence, UT 84332-9707
Phone
(435) 994-7500
NPI assigned
Nov 3, 2023
Last updated
Nov 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Authorized official

Name
Ryan Stolworthy, MDNPI 1417981234
Title
Co-Founder
Phone
(435) 757-7534

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

169 N Gateway Dr # 110
Providence, UT 84332-9707

Mailing address

PO Box 369
Hyde Park, UT 84318-0369
Phone (435) 994-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250416002298 UT Part B Supplier - Clinic/Group Practice 4981129517 Receives reassigned benefits from 1 practitioner
Practice locations: Logan, UT

National Provider Directory

National Provider Directory

Locations

965 S 100 W
Ste 203
Logan, UT 84321
Phone (435) 752-1976

169 N Gateway Dr
Ste 110
Providence, UT 84332
Phone (435) 760-7763

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698969600000",
    "number": "1306619044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "city": "HYDE PARK",
            "state": "UT",
            "postal_code": "843180369",
            "telephone_number": "435-994-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 N GATEWAY DR # 110",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843329707",
            "telephone_number": "435-994-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAZ WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A",
        "authorized_official_last_name": "STOLWORTHY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "435-757-7534",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.