Therapeutic Lifestyle Center of Utah

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

THERAPEUTIC LIFESTYLE CENTER OF UTAH

Practice address

1151 E 3900 S Ste B175
Salt Lake City, UT 84124-1255

Phone

(801) 691-7064

NPI assigned

Dec 7, 2018

Organization subpart

No

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

Authorized official

Name

Sasha Kihm

Title

Administrative Director

Phone

(801) 691-7064

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1544140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544140800000",
    "number": "1770054348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 E 3900 S STE B175",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 E 3900 S STE B175",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241255",
            "telephone_number": "801-691-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC LIFESTYLE CENTER OF UTAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-07",
        "last_updated": "2018-12-07",
        "status": "A",
        "authorized_official_last_name": "KIHM",
        "authorized_official_first_name": "SASHA",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "801-691-7064"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace M Theodoro, M.D.
• Sophia Katerina Theodossiou
• Theory and Method Therapy Collective
• Amy Theos, MD
• Therapeak, Inc.
• Theresa Ipolito LCSW PLLC
• Kevin Theriot, PH.D.
• Craig Brook Theurer, D.D.S.
• Daniel Jay Theurer, D.D.S.
• Jared M Theurer, D.D.S.

• Psychiatric/Mental Health Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; 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.