NPIMap

Organization Active NPI

Fairbourne Group

  • Mental Health Counselor
  • Salt Lake City, UT
National Provider Identifier
1831898352
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
FAIRBOURNE GROUP
Practice address
145 E 900 S Ste 6
Salt Lake City, UT 84111-4241
Phone
(385) 722-4505
NPI assigned
Feb 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Authorized official

Name
Caitlin Galt, CMHCNPI 1063118693
Title
Owner/Director
Phone
(801) 608-1934

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

145 E 900 S Ste 6
Salt Lake City, UT 84111-4241

Mailing address

145 E 900 S Ste 6
Salt Lake City, UT 84111-4241
Phone (385) 722-4505

National Provider Directory

National Provider Directory

Locations

145 E 900 S
Ste 6
Salt Lake City, UT 84111
Phone (385) 722-4505

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1831898352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 E 900 S STE 6",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841114241",
            "telephone_number": "385-722-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 E 900 S STE 6",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841114241",
            "telephone_number": "385-722-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBOURNE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-23",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "GALT",
        "authorized_official_first_name": "CAITLIN",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "801-608-1934",
        "authorized_official_credential": "CMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Feb 23, 2023; 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.