Individual provider Active NPI

Sara Kay Fawson, RBT

  • Behavior Technician
  • Salt Lake City, UT
National Provider Identifier
1669874350
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
176758965 Issued in UT
Practice address
358 S 700 E Ste B307
Salt Lake City, UT 84102-2161
Phone
(801) 935-5796
NPI assigned
Sep 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Behavior Technician 106S00000X 176758965 UT Primary

Addresses

Primary practice location

358 S 700 E Ste B307
Salt Lake City, UT 84102-2161

Mailing address

1585 N 400 E Apt 533
North Logan, UT 84341-7587
Phone (435) 830-1895

Other practice location 1

935 e 2985 N
Layton, UT 84040
Phone (801) 564-1748

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

LicenseStateTypeSpecialty
176758965UTMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1669874350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 N 400 E APT 533",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843417587",
            "telephone_number": "435-830-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 S 700 E STE B307",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022161",
            "telephone_number": "801-935-5796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "935 e 2985 N",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "84040",
            "country_code": "US",
            "telephone_number": "801-564-1748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAWSON",
        "first_name": "SARA",
        "middle_name": "KAY",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "UT",
            "license": "176758965",
            "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 Dec 5, 2019; 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.