Active NPI
Transformative Care
- Counseling Psychologist
- Salt Lake City, UT
National Provider Identifier
1649891953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- Legal business name
- TRANSFORMATIVE CARE
- Practice address
- 4055 S 700 E Ste 102F
Salt Lake City, UT 84107-2174 - Phone
- (801) 618-0852
- NPI assigned
- Apr 28, 2020
- Last updated
- Apr 28, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jamie Leigh Bustamante, PHD
- Title
- Psychologist
- Phone
- (801) 618-0852
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | NU | Primary |
Addresses
Primary practice location
4055 S 700 E Ste 102F
Salt Lake City, UT 84107-2174
Mailing address
1187 E Charlton Ave
Salt Lake City, UT 84106-2603
Phone (928) 607-4677
National Provider Directory
National Provider DirectoryLocations
4055 S 700 E
Ste 102F
Salt Lake City, UT 84107
Phone (435) 200-4767
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.
-
- Counseling Psychologist
- Salt Lake City, UT
- NPI 1982097127
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588032000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1588032000000",
"number": "1649891953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1187 E CHARLTON AVE",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841062603",
"telephone_number": "928-607-4677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4055 S 700 E STE 102F",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841072174",
"telephone_number": "801-618-0852"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRANSFORMATIVE CARE",
"organizational_subpart": "NO",
"enumeration_date": "2020-04-28",
"last_updated": "2020-04-28",
"certification_date": "2020-04-28",
"status": "A",
"authorized_official_last_name": "BUSTAMANTE",
"authorized_official_first_name": "JAMIE",
"authorized_official_middle_name": "LEIGH",
"authorized_official_title_or_position": "PSYCHOLOGIST",
"authorized_official_telephone_number": "801-618-0852",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NU",
"license": null,
"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 Apr 28, 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.