Wasatch Behavioral Health Special Service District

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

WASATCH BEHAVIORAL HEALTH SPECIAL SERVICE DISTRICT

Practice address

255 S Orem Blvd
Orem, UT 84058-3009

Phone

(801) 373-4760

NPI assigned

Aug 29, 2023

Last updated

Jul 18, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

WASATCH BEHAVIORAL HEALTH SPECIAL SERVICE DISTRICTAs reported in NPPES

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

Authorized official

Name

Juergen E Korbanka, PH.D.NPI 1386600450

Title

Executive Director

Phone

(801) 852-4703

Specialties & licenses 1

Addresses

Other names 1

• Wasatch Behavioral Health Special Service District Laboratory Other name

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Wasatch Behavioral Health Special Service District

  • Community/Behavioral Health Agency
  • Provo, UT
  • NPI 1356357115

  2567367915

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Fuller Psychological and Family Services2 organizations share this tax ID, including this one

Part of

Fuller Psychological and Family Services

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wasatch Behavioral Health Special Service District

  • Community/Behavioral Health Agency
  • Provo, UT
  • NPI 1356357115
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Wasatch Behavioral Health Special Service District

  • Community/Behavioral Health Agency
  • Provo, UT
  • NPI 1356357115
  NPPES parent name

Practitioners 262

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.

• Juergen Erich Korbanka, PHD

  • Clinical Psychologist
  • Provo, UT
  • NPI 1386600450
  NPD (past) Authorized official
• Diana Laree Akan

  • Marriage & Family Therapist
  • Provo, UT
  • NPI 1750055174
  NPD
• David Harry Alddell

  • Clinical Social Worker
  • Provo, UT
  • NPI 1780319897
  NPD
• Rebecca Allen

  • Clinical Social Worker
  • Provo, UT
  • NPI 1306573779
  NPD
• Dean Foisy Anderson, LCSW

  • Clinical Social Worker
  • Provo, UT
  • NPI 1982716197
  NPD
• Tyler J Anderson, MD, MHA

  • Psychiatry Physician
  • Lehi, UT
  • NPI 1356633143
  NPD
• Samuel L Ashton, MFTI

  • Marriage & Family Therapist
  • Provo, UT
  • NPI 1144321779
  NPD
• Jennifer Atwood, LCSW

  • Clinical Social Worker
  • Provo, UT
  • NPI 1386856920
  NPD
• Erin Beth Awerkamp, LCSW

  • Clinical Social Worker
  • Provo, UT
  • NPI 1033692439
  NPD
• Meredith I Bailey

  • Case Manager/Care Coordinator
  • Provo, UT
  • NPI 1669969150
  NPD
• Dallas Bean

  • Clinical Social Worker
  • Sandy, UT
  • NPI 1013215599
  NPD
• Lynette Michelle Beard, CSW

  • Clinical Social Worker
  • Provo, UT
  • NPI 1851698914
  NPD

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752796800000",
    "number": "1669257556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD STE 300",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011690",
            "telephone_number": "801-374-4760",
            "fax_number": "801-373-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S OREM BLVD",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840583009",
            "telephone_number": "801-373-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASATCH BEHAVIORAL HEALTH SPECIAL SERVICE DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WASATCH BEHAVIORAL HEALTH SPECIAL SERVICE DISTRICT",
        "enumeration_date": "2023-08-29",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A",
        "authorized_official_last_name": "KORBANKA",
        "authorized_official_first_name": "JUERGEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-852-4703",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wasatch Behavioral Health Special Service District Laboratory",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Wasatch Behavioral Health Special Service District Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kelly D Warner
• Simon Phillip Warner
• Connie Louise Warr, FNP
• Warren a Peterson, D.O.
• Dawn Raine Wartz
• Wasatch Foot and Ankle Specialists LLC
• Wasatch Medical Center
• Wasatch Mental Health
• Wasatch Neonatal LC (Wasatch Neonatal)
• Sarah Kelly Wasden

• Clinical Medical Laboratory in Orem, UT
• Providers in Orem, UT by specialty
• Clinical Medical Laboratory in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.