Summit County Clubhouse

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Legal business name

SUMMIT COUNTY CLUBHOUSE

Practice address

1283 Deer Valley Dr
Park City, UT 84060-5182

Phone

(801) 930-0277

NPI assigned

Sep 19, 2019

Organization subpart

No

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

Authorized official

Name

Amber Mackay, SSWNPI 1104124882

Title

Executive Director

Phone

(801) 930-0277

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Amber Mackay

  • Mental Health Counselor
  • Salt Lake City, UT
  • NPI 1104124882
  NPD Authorized official

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1902456148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 680861",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840680861",
            "telephone_number": "801-930-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1283 DEER VALLEY DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840605182",
            "telephone_number": "801-930-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT COUNTY CLUBHOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-19",
        "last_updated": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "MACKAY",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-930-0277",
        "authorized_official_credential": "SSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003101",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://cos-stage-scc.azurewebsites.net/Account/Login?ReturnUrl=%2F",
            "affiliation": "Y",
            "endpointDescription": "Clubhouse Data Platform",
            "address_1": "12166 S Redwood Rd",
            "city": "Riverton",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840657410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karen R Stolman, MD
• Christopher Stoner, D.O.
• Tarah Rachele Stowell, L.C.S.W.
• Successware LLC
• Jessica Sullenberger
• Summit County Early Intervention
• Summit Sports Performance and Rehab Center, PLLC
• Jeffrey Rex Sumsion, DMD, MS
• Sundance Counseling LLC
• Pamela L Sunshine, PA-C

• Case Manager/Care Coordinator in Park City, UT
• Providers in Park City, UT by specialty
• Case Manager/Care Coordinator in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.