Sanctuary for Healing & Integration PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

280094-1205 Issued in UT

Legal business name

SANCTUARY FOR HEALING & INTEGRATION PLLC

Practice address

860 E 4500 S Ste 302
Salt Lake City, UT 84107-3018

Phone

(801) 268-0333

Fax

(801) 268-3777

NPI assigned

Jun 6, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Carmela J Javellana, M.D.NPI 1215031778

Title

Owner

Phone

(801) 268-0333

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 1

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

• Carmela J Javellana, MD

  • Psychiatry Physician
  • Bountiful, UT
  • NPI 1215031778
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338940800000",
    "number": "1417218371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 E 4500 S STE 302",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841073018",
            "telephone_number": "801-268-0333",
            "fax_number": "801-268-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 E 4500 S STE 302",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841073018",
            "telephone_number": "801-268-0333",
            "fax_number": "801-268-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANCTUARY FOR HEALING & INTEGRATION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A",
        "authorized_official_last_name": "JAVELLANA",
        "authorized_official_first_name": "CARMELA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-268-0333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "280094-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.