1922145507 NPI number — ALBION ASSESMENT & PSYCHOTHERAPY ASSOCIATES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922145507 NPI number — ALBION ASSESMENT & PSYCHOTHERAPY ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALBION ASSESMENT & PSYCHOTHERAPY ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922145507
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
555 E 4500 S
Provider Second Line Business Mailing Address:
SUITE C-150
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84107-4533
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-288-0747
Provider Business Mailing Address Fax Number:
801-288-0761

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1414 E 4500 S
Provider Second Line Business Practice Location Address:
#4A
Provider Business Practice Location Address City Name:
SALT LAKE CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84117-4228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-274-6700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HOPPS
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
K
Authorized Official Title or Position:
PSYCHOLOGIST
Authorized Official Telephone Number:
801-274-6700

Provider Taxonomy Codes

  • Taxonomy code: 103TC2200X , with the licence number:  1157832501 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 550335430012 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".




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