Susan Imhoff Bird

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

288938-3501 Issued in UT

Legal business name

SUSAN IMHOFF BIRD

Practice address

4505 S Wasatch Blvd Ste 320
Salt Lake City, UT 84124-4755

Phone

(801) 541-5205

Fax

(801) 541-5205

NPI assigned

Sep 20, 2017

Organization subpart

No

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

Authorized official

Name

Susan Imhoff Bird, LCSWNPI 1386153534

Title

Owner

Phone

(801) 541-5205

Specialties & licenses 1

Addresses

Other names 1

• Centered Earth Counseling Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Imhoff Bird, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
  • NPI 1386153534
  NPD (past) Authorized official

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505865600000",
    "number": "1750890935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 E 1700 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841082716",
            "telephone_number": "801-541-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 S WASATCH BLVD STE 320",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841244755",
            "telephone_number": "801-541-5205",
            "fax_number": "801-541-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN IMHOFF BIRD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2017-09-20",
        "status": "A",
        "authorized_official_last_name": "BIRD",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "IMHOFF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-541-5205",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "UT",
            "license": "288938-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centered Earth Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natalie Surut, PT, DPT
• Amit Surve, MD
• Survive & Thrive Therapy Services, PLLC
• Mandy Susaeta
• Susan Curtis, CMHC, PC
• Briana Susca
• Kaytelin G. Suslavich, MD
• Joseph Michael Sussi
• Yesenia Sustaita
• Harold Pratt Sutherland Jr Jr., M.D.

• Clinic/Center in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; 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.