Organization Active NPI

Transformative Care

  • Counseling Psychologist
  • Salt Lake City, UT
National Provider Identifier
1649891953
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
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, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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

Authorized official

Name
Jamie Leigh Bustamante, PHDNPI 1982097127
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)CodeLicenseStatePrimary
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 Directory

Locations

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.

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.

Verify at the official NPI Registry.