NPIMap

Organization Active NPI

Mountain Ridge Behavioral Health Center

  • Clinical Psychologist
  • Mapleton, UT
National Provider Identifier
1902626153
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
MOUNTAIN RIDGE BEHAVIORAL HEALTH CENTER
Practice address
704 S 1600 W Ste 104
Mapleton, UT 84664-4462
Phone
(801) 491-6394
Fax
(801) 491-6613
NPI assigned
Oct 14, 2024
Last updated
Oct 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Authorized official

Name
Summer SimmonsNPI 1376239715
Title
Practice Manager
Phone
(385) 482-3688

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

704 S 1600 W Ste 104
Mapleton, UT 84664-4462

Mailing address

704 S 1600 W Ste 104
Mapleton, UT 84664-4462
Phone (801) 491-6394

Other practice location 1

3305 N University Ave Ste 275
Provo, UT 84604-7406
Phone (801) 491-6394

National Provider Directory

National Provider Directory

Locations

704 S 1600 W
Ste 104
Mapleton, UT 84664
Phone (801) 491-6394

3305 N University Ave
Ste 275
Provo, UT 84604
Phone (801) 491-6394

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1728864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1902626153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 S 1600 W STE 104",
            "city": "MAPLETON",
            "state": "UT",
            "postal_code": "846644462",
            "telephone_number": "801-491-6394",
            "fax_number": "801-491-6613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 S 1600 W STE 104",
            "city": "MAPLETON",
            "state": "UT",
            "postal_code": "846644462",
            "telephone_number": "801-491-6394",
            "fax_number": "801-491-6613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3305 N University Ave Ste 275",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846047406",
            "country_code": "US",
            "telephone_number": "801-491-6394",
            "fax_number": "801-491-6613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOUNTAIN RIDGE BEHAVIORAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-13",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "SUMMER",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "385-482-3688"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mapleton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.