Family Development Center

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

108286-2501 Issued in UT

Legal business name

FAMILY DEVELOPMENT CENTER

Practice address

8817 Redwood Rd Ste a
West Jordan, UT 84088-9266

Phone

(801) 748-2270

Fax

(801) 748-2271

NPI assigned

Aug 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Terry Lee Burnham, PHD

Title

Psychologist

Phone

(801) 748-2270

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346354875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8817 REDWOOD RD STE A",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889266",
            "telephone_number": "801-748-2270",
            "fax_number": "801-748-2271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8817 REDWOOD RD STE A",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889266",
            "telephone_number": "801-748-2270",
            "fax_number": "801-748-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURNHAM",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "801-748-2270",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "108286-2501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF UTAH",
            "identifier": "52954286702001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Clinical Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.