Family Support Center

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

17461 Issued in UT

Legal business name

FAMILY SUPPORT CENTER

Practice address

3663 S 3600 W
West Valley City, UT 84119-2570

Phone

(801) 967-4259

Fax

(801) 964-1534

NPI assigned

Jun 7, 2011

Organization subpart

No

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) 995-9110

Specialties & licenses 1

Addresses

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.

• Family Support Center

  • Mental Health Counselor
  • Salt Lake City, UT
  • NPI 1730473786
  NPD tax ID
• Family Support Center

  • Mental Health Counselor
  • Taylorsville, UT
  • NPI 1801181599
  NPD tax ID

Locations

Practitioners 1

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

• Halie Boardman, CSW

  • Social Worker
  • West Valley City, UT
  • NPI 1356640767
  NPD (past)

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": "1821382771",
    "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": "801-955-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3663 S 3600 W",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841192570",
            "telephone_number": "801-967-4259",
            "fax_number": "801-964-1534"
        }
    ],
    "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": "801-995-9110",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "17461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reed Evers, MD
• Brian Howard Ewell, D.C.
• Robert Ewing
• Alyson Eyre, MD
• Jeelan Fall
• Emily Marie Fatali, LCSW
• Jannah Lee Faumuina
• Andrew Fedoravicius, MD
• Matthew E. Feil, DO
• Leilani Felise

• Mental Health Counselor in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Mental Health Counselor in Utah

• 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.