Active NPI
Kaitlin Flanagan, PSYD
- Clinical Psychologist
- Salt Lake City, UT
National Provider Identifier
1629647045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 11869069-2501
- Practice address
- 170 S 1000 E Ste 201
Salt Lake City, UT 84102-1403 - Phone
- (801) 419-0139
- NPI assigned
- Jun 21, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 11869069-2501 | UT | Primary |
Addresses
Primary practice location
170 S 1000 E Ste 201
Salt Lake City, UT 84102-1403
Mailing address
1713 E Downington Ave
Salt Lake City, UT 84108-2909
Phone (650) 269-8033
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11869069-2501 | UT | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Perspective Behavioral Health | Multi-Specialty | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624233600000",
"number": "1629647045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1713 E DOWNINGTON AVE",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841082909",
"telephone_number": "650-269-8033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 S 1000 E STE 201",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841021403",
"telephone_number": "801-419-0139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLANAGAN",
"first_name": "KAITLIN",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-21",
"last_updated": "2021-06-21",
"certification_date": "2021-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "11869069-2501",
"primary": true
}
],
"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 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.