Utah State University
Organization Active NPI Behavior Analyst · Logan, UT
NPI 1629619010 · NPPES record last updated Oct 7, 2019
Key facts
- NPI
- 1629619010
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Behavior Analyst 103K00000X
- Legal business name
- UTAH STATE UNIVERSITY
- Practice address
- 6405 Old Main Hill
Logan, UT 84322-0001 - Phone
- (435) 797-0576
- Fax
- (844) 308-5865
- NPI assigned
- Oct 7, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- UTAH STATE UNIVERSITY
Authorized official
- Name
- Kathryn Clements
- Title
- Controller
- Phone
- (435) 797-5830
Corporate family (same tax ID) 11
National Provider Directory
- Tax ID family
- Utah State University
- Part of
- Utah State University
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst |
103K00000X | Yes |
Addresses
Primary practice location
6405 Old Main Hill
Logan, UT 84322-0001
Mailing address
6405 Old Main Hill
Logan, UT 84322-0001
Phone (435) 797-0576
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447715701 | Medicaid | UT |
Other names
- Sorenson Center Behavior Support Services
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | LOGAN | Other |
Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.