Organization Active NPI

Tri-Peak, PLLC

  • Psychologist
  • Salt Lake City, UT
National Provider Identifier
1922403765
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
8699894-2501 Issued in UT
Legal business name
TRI-PEAK, PLLC
Practice address
4535 S 2300 E
Suite B
Salt Lake City, UT 84117
Phone
(801) 821-3962
NPI assigned
Oct 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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

Authorized official

Name
Jessica Graham, PSYD
Title
Director of Clinical Services
Phone
(801) 821-3962

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 8699894-2501 UT Primary

Addresses

Primary practice location

4535 S 2300 E
Suite B
Salt Lake City, UT 84117

Mailing address

4535 S 2300 E
Suite B
Salt Lake City, UT 84117

Other names 1

  • Tri-Peak Wellness Doing business as

National Provider Directory

National Provider Directory

Locations

4535 S 2300 E
#B
Salt Lake City, UT 84117
Phone (801) 821-3962

NPI Registry JSON

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1922403765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 S 2300 E",
            "address_2": "SUITE B",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 S 2300 E",
            "address_2": "SUITE B",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84117",
            "telephone_number": "801-821-3962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-PEAK, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-22",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "801-821-3962",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "UT",
            "license": "8699894-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri-Peak Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 22, 2014; 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.