NPIMap

Organization Active NPI

Realign Psychology LLC

  • Clinical Psychologist
  • Midvale, UT
National Provider Identifier
1467073833
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
REALIGN PSYCHOLOGY LLC
Practice address
1042 E Fort Union Blvd
#1085
Midvale, UT 84047-1800
Phone
(801) 382-8702
NPI assigned
Apr 27, 2020
Last updated
Apr 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Authorized official

Name
Dr. Melissa Ellsworth, PHDNPI 1285261230
Title
Clinical Psychologist
Phone
(240) 478-8892

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

1042 E Fort Union Blvd
#1085
Midvale, UT 84047-1800

Mailing address

1258 Piper LN
Eugene, OR 97401-1868
Phone (240) 478-8892

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address melissa@realignpsych.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1587945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587945600000",
    "number": "1467073833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1258 PIPER LN",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974011868",
            "telephone_number": "240-478-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1042 E FORT UNION BLVD",
            "address_2": "#1085",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471800",
            "telephone_number": "801-382-8702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REALIGN PSYCHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A",
        "authorized_official_last_name": "ELLSWORTH",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "240-478-8892",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "melissa@realignpsych.com",
            "affiliation": "N",
            "endpointDescription": "business e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1042 E Fort Union Blvd # 1085",
            "city": "Midvale",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840471800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.