City Center Psychology, PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CITY CENTER PSYCHOLOGY, PLLC

Practice address

175 S Main St Ste 840
Salt Lake City, UT 84111-1924

Phone

(385) 831-0200

NPI assigned

Aug 30, 2018

Last updated

Mar 8, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jinna Lee, PHDNPI 1073885091

Title

Director

Phone

(385) 831-0200

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

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.

• Jinna Lee, PHD

  • Psychologist
  • Salt Lake City, UT
  • NPI 1073885091
  NPD Authorized official

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1730661349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 S MAIN ST STE 840",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841111924",
            "telephone_number": "385-831-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S MAIN ST STE 840",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841111924",
            "telephone_number": "385-831-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY CENTER PSYCHOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-30",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JINNA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "385-831-0200",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@citycenterpsych.com",
            "affiliation": "N",
            "address_1": "175 S Main St Ste 840",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841111924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aura Cisneros-Gonzalez
• Damian Cisneros-Pasillas
• Cora Cisneros
• Natalie Adair Cisney, PA
• Brittney Pauline Ciszek, DDS, PHD
• City Creek Dental, PLLC
• City Creek Medical Specialists, Inc
• City Creek Senior Living LLC
• City Creek Surgical Services
• City of South Salt Lake

• Mental Health Clinic/Center (Including Community Mental Health Center) in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.