Amanda Butler
Individual provider Active NPI Marriage & Family Therapist · Sandy, UT
NPI 1699387134 · NPPES record last updated Aug 17, 2020
Key facts
- NPI
- 1699387134
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 11753608-3904 (UT)
- Practice address
- 9035 S 1300 E Ste 120
Sandy, UT 84094-3192 - Phone
- (801) 455-0045
- NPI assigned
- Aug 17, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11753608-3904 | UT | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amber Creek Counseling and Psychiatry Inc | Marriage & Family Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 11753608-3904 | UT | Yes |
Addresses
Primary practice location
9035 S 1300 E Ste 120
Sandy, UT 84094-3192
Mailing address
2650 E 3300 S Apt 1
Salt Lake City, UT 84109-2711
Phone (801) 808-5290
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11753608-3904 | Other | UT | DIVISION OF OCCUPATIONAL & PROFESSIONAL LICENSING |
Other providers in Sandy, UT
- Jenny Bunnell
- Justin James Burk
- Rachel Zorko Burris
- Mia Kate Burtch
- Piper Butcher
- Isaac Butler
- Bybee Home Care LLC
- Bybee Home Care LLC
- Chase Bynum
- Kyle Byrnes
All providers in Sandy, UT · Marriage & Family Therapist in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.