Individual provider Active NPI

Damon Paul Bryan, MS

  • Marriage & Family Therapist
  • Holladay, UT
National Provider Identifier
1609056472
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
5406203-3902 Issued in UT
Practice address
2290 E 4500 S Ste 180
Holladay, UT 84117-4493
Phone
(970) 403-2458
NPI assigned
Nov 9, 2007
Last updated
Nov 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 5406203-3902 UT Primary

Addresses

Primary practice location

2290 E 4500 S Ste 180
Holladay, UT 84117-4493

Mailing address

2290 E 4500 S Ste 180
Holladay, UT 84117-4493
Phone (970) 259-2162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5406203-3902UTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Canyon Counseling, PLLC CurrentSince Nov 6, 2022 Accepting new patients
Gibson Ventures, LLC Past Accepting new patients

Locations

2290 E 4500 S
Ste 180
Salt Lake City, UT 84117
Phone (385) 285-8350

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1609056472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 E 4500 S STE 180",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841174493",
            "telephone_number": "970-259-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 E 4500 S STE 180",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841174493",
            "telephone_number": "970-403-2458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "DAMON",
        "middle_name": "PAUL",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-09",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "5406203-3902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holladay, UT

Sources for this page

Verify at the official NPI Registry.