Pinebrook Mental Health Therapy Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PINEBROOK MENTAL HEALTH THERAPY INC.

Practice address

3100 Pinebrook Rd Ste 1250B
Park City, UT 84098-5663

Phone

(435) 562-1903

NPI assigned

Oct 23, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Jacqueline Hyde, PSYD, CMHCNPI 1003002544

Title

Ceo

Phone

(435) 562-1903

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Hyde

  • Professional Counselor
  • Sandy, UT
  • NPI 1003002544
  NPD Authorized official

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734825600000",
    "number": "1659192425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 PINEBROOK RD STE 1250B",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985663",
            "telephone_number": "435-562-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 PINEBROOK RD STE 1250B",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985663",
            "telephone_number": "435-562-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEBROOK MENTAL HEALTH THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-12-22",
        "certification_date": "2024-12-22",
        "status": "A",
        "authorized_official_last_name": "HYDE",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "435-562-1903",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, CMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pharmacy at Park City Clinic
• Jennifer Philips
• Christine Margaret Phillips, D.C.
• William Pidwell
• Pinebrook Dental Group
• Pineview Dental Health PLLC
• Zachariah Pinter, MD
• Nancy Pollard
• Stephanie Anne Polukoff, OTR/L
• Elena Diane Polychronis

• Mental Health Counselor in Park City, UT
• Providers in Park City, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2024; 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.