Jared Sanford

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Salt Lake City, UT

NPI 1407150758 · NPPES record last updated Dec 12, 2023

Key facts

NPI
1407150758
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
4460 S Highland Dr
Salt Lake City, UT 84124-3543
Phone
(888) 949-4864
NPI assigned
Dec 30, 2010
Sex
Male
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Valleyfit Clinic LLC Current Accepting new patients
Valleylab Current Accepting new patients
Valleyrx Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

4460 S Highland Dr
Salt Lake City, UT 84124-3543

Mailing address

3725 W 4100 S Ste 201
West Valley City, UT 84120-5427
Phone (888) 949-4864

Other providers in Salt Lake City, UT

All providers in Salt Lake City, UT · Addiction (Substance Use Disorder) Counselor in Utah

Sources for this page

Verify at the official NPI Registry.