Child&Family Institute for Assessment and Psychotherapy, LLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

377761-2501 Issued in UT

Legal business name

CHILD&FAMILY INSTITUTE FOR ASSESSMENT AND PSYCHOTHERAPY, LLC

Practice address

1910 Prospector Ave
Suite 201
Park City, UT 84060-7211

Phone

(435) 645-9240

Fax

(435) 645-9237

NPI assigned

Mar 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Santosusso Gale, PSY.D.

Title

Owner/Pediatric Neuropsychologist

Phone

(435) 645-9240

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Child & Family Institute, LLC Doing business as

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902865595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 PROSPECTOR AVE",
            "address_2": "SUITE 201",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607211",
            "telephone_number": "435-645-9240",
            "fax_number": "435-645-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 PROSPECTOR AVE",
            "address_2": "SUITE 201",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607211",
            "telephone_number": "435-645-9240",
            "fax_number": "435-645-9237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD&FAMILY INSTITUTE FOR ASSESSMENT AND PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GALE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "SANTOSUSSO",
        "authorized_official_title_or_position": "OWNER/PEDIATRIC NEUROPSYCHOLOGIST",
        "authorized_official_telephone_number": "435-645-9240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "UT",
            "license": "377761-2501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149727806001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Child & Family Institute, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Center for Team Healthcare
• Robert D. Cervantez, PT
• Jordan Chamberlain, MA, BCBA
• Scott M Chandler, DMD
• Sierra Chapman, PT, DPT
• Ian T Christensen, MD
• Christian Center of Park City
• Tyrene L Christopulos, OT
• Jennifer A Chrystan, PH.D.
• Emil Chuang, MD

• Clinical Neuropsychologist in Park City, UT
• Providers in Park City, UT by specialty
• Clinical Neuropsychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.