Utah Lakes Neuroscience Mental Health Center PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

UTAH LAKES NEUROSCIENCE MENTAL HEALTH CENTER PLLC

Practice address

3549 N University Ave Ste 200
Provo, UT 84604-4417

Phone

(385) 265-2484

Fax

(877) 894-5104

NPI assigned

Apr 1, 2020

Last updated

Apr 2, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Liliana Roney, LCSWNPI 1114577202

Title

Owner

Phone

(385) 265-2484

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Liliana Roney

  • Clinical Social Worker
  • Taylorsville, UT
  • NPI 1114577202
  NPD Authorized official

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585785600000",
    "number": "1609404813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 W COUGAR BLVD # 704",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042546",
            "telephone_number": "385-265-2484",
            "fax_number": "877-894-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3549 N UNIVERSITY AVE STE 200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846044417",
            "telephone_number": "385-265-2484",
            "fax_number": "877-894-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH LAKES NEUROSCIENCE MENTAL HEALTH CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-01",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A",
        "authorized_official_last_name": "RONEY",
        "authorized_official_first_name": "LILIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "385-265-2484",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE",
            "identifier": "11486773-3501",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Utah County Public Defender Association
• Utah CVS Pharmacy LLC (CVS Pharmacy #10230)
• Utah CVS Pharmacy, L.L.C. (CVS Pharmacy #17911)
• Utah Home Health and Hospice LLC
• Utah Integrative Psychiatry & Addiction Medicine
• Utah Neurological Clinic, PC
• Utah Neurological Clinic, PC
• Utah Neurological Clinic, PC
• Utah Podiatry Group PC (Advanced Foot & Ankle Center)
• Utah Psychological Associates, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.