Wasatch Back Venture Trail

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

WASATCH BACK VENTURE TRAIL

Practice address

3585 N University Ave Ste 250
Provo, UT 84604-6622

Phone

(435) 513-2715

NPI assigned

Aug 7, 2020

Organization subpart

No

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

Authorized official

Name

Megan Perry

Title

Owner

Phone

(435) 513-2715

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596758400000",
    "number": "1407466089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 N UNIVERSITY AVE STE 250",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046622",
            "telephone_number": "435-513-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3585 N UNIVERSITY AVE STE 250",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046622",
            "telephone_number": "435-513-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASATCH BACK VENTURE TRAIL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-07",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-513-2715"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Russell Warnick, MD
• Sharon E Warnock, FNP
• Ashlyn M Warren
• Brittany Ann Warren
• Jared Scott Warren, PH.D.
• Wasatch Behavioral Health Special Service District
• Wasatch Mental Health
• Wasatch Mental Health
• Wasatch Mental Health
• Wasatch Mental Health

• Social Worker in Provo, UT
• Providers in Provo, UT by specialty
• Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.