Organization Active NPI

Rural Therapy Network

  • Mental Health Counselor
  • Salt Lake City, UT
National Provider Identifier
1558114348
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
RURAL THERAPY NETWORK
Practice address
343 N 300 W
Salt Lake City, UT 84103-1215
Phone
(406) 272-2440
NPI assigned
Apr 10, 2024
Last updated
Jun 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Authorized official

Name
Malia Kealana Burgess
Title
Owner
Phone
(406) 272-2440

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X Primary
Clinical Social Worker 1041C0700X
Marriage & Family Therapist 106H00000X

Addresses

Primary practice location

343 N 300 W
Salt Lake City, UT 84103-1215

Mailing address

1935 W 4700 S # 322
Taylorsville, UT 84129-1105
Phone (406) 272-2440

National Provider Directory

National Provider Directory

Locations

343 N 300 W
Salt Lake City, UT 84103
Phone (406) 272-2440

1935 W 4700 S
Taylorsville, UT 84129

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": "1712707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1558114348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 W 4700 S # 322",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841291105",
            "telephone_number": "406-272-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 N 300 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841031215",
            "telephone_number": "406-272-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL THERAPY NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-10",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "MALIA",
        "authorized_official_middle_name": "KEALANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-272-2440"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.