NPIMap

Organization Active NPI

Family Support Center

  • Mental Health Counselor
  • Salt Lake City, UT
National Provider Identifier
1730473786
Registry record updated Jun 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
17460 Issued in UT
Legal business name
FAMILY SUPPORT CENTER
Practice address
2020 Lake St
Salt Lake City, UT 84105-3119
Phone
(801) 487-7778
Fax
(801) 487-2942
NPI assigned
Jun 7, 2011
Last updated
Jun 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2011

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

Authorized official

Name
Mr. Paul M Ricks, LCSW
Title
Clinical Director
Phone
(801) 955-9110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 17460 UT Primary

Addresses

Primary practice location

2020 Lake St
Salt Lake City, UT 84105-3119

Mailing address

1760 W 4805 S
Taylorsville, UT 84118-1177
Phone (801) 955-9110

National Provider Directory

National Provider Directory
Tax ID family
Family Support Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 4

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": "1307404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307404800000",
    "number": "1730473786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 W 4805 S",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841181177",
            "telephone_number": "801-955-9110",
            "fax_number": "801-955-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 LAKE ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053119",
            "telephone_number": "801-487-7778",
            "fax_number": "801-487-2942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SUPPORT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A",
        "authorized_official_last_name": "RICKS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "801-955-9110",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "17460",
            "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 Jun 7, 2011; 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.