Lillian Bob Adolphson, BCBA-D
Individual provider Active NPI Behavior Analyst · Salt Lake City, UT
NPI 1932467776 · NPPES record last updated Sep 22, 2022
Key facts
- NPI
- 1932467776
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-11-8304
- Practice address
- 1789 E Logan Ave
Salt Lake City, UT 84108-2629 - Phone
- (801) 550-3546
- NPI assigned
- Apr 30, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 800311-2506 | UT | MD | Behavioral Analyst |
| 311800-3503 | UT | MD | Social Worker |
| 2022037088 | UT | MD | Intermediate Emergency Medical Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joyful Journeys Therapy LLC | Behavior Analyst | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 800311-2506 | UT | |
| Social Worker | 104100000X | 311800-3503 | UT | |
| Intermediate Emergency Medical Technician | 146M00000X | 2022037088 | UT | |
| Behavior Analyst | 103K00000X | 1-11-8304 | Yes |
Addresses
Primary practice location
1789 E Logan Ave
Salt Lake City, UT 84108-2629
Mailing address
1789 E Logan Ave
Salt Lake City, UT 84108-2629
Phone (801) 550-3546
Other names
- Dr. Sarah Lillian Adolphson
Other providers in Salt Lake City, UT
- Teresa Marie Adkins
- Audrey Violet Adler
- Lezlie Joan Adler
- Adolescent, Child and Family Therapy Clinic, Inc
- Laura N Adolfson
- Drew Adriaens
- Cara Adrian
- Adult Care Clinic Inc
- Advanced Autism Services Ut LLC
- Advanced Behavior Analysis
All providers in Salt Lake City, UT · Behavior Analyst in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.