GATEWAY ACADEMY, LLC (NPI# 1205291739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205291739 |
| Entity Type | Organization |
| Organization Name | GATEWAY ACADEMY, LLC |
| Practice Address |
1390 S 1100 E Ste 203 Salt Lake City UT 84105-2463 |
| Practice Telephone | 8015233479 |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2016-10-12 |
| Authorized Official Name | ANGIE EVANS (BO) |
| Authorized Official Telephone | 8017666604 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
17567 | UT | Ambulatory Health Care Facilities |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
31810 | UT | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720456981 | Gateway Academy, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 941 E Cattail Dr, Draper, UT 84020-8583 | 2015-09-04 |
| 1427425859 | Gateway Academy, LLC | Community Based Residential Treatment Facility, Mental Illness | 2487 S 700 E, Salt Lake City, UT 84106-1722 | 2015-09-02 |
| Street Address |
1390 S 1100 E STE 203 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84105-2463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922107671 | Julie Ann Wright | Counselor | 1390 S 1100 E Ste 203, Salt Lake City, UT 84105-2463 | 2006-09-21 |
| 1952883589 | Susan Curtis, Cmhc, PC | Clinic/Center | 1390 S 1100 E Ste 203, Salt Lake City, UT 84105 | 2018-08-30 |
| 1316235070 | Stokes Smith | Counselor | 1390 S 1100 E Ste 203, Salt Lake City, UT 84105-2463 | 2011-07-15 |
| 1962702936 | Stephanie Foster | Counselor | 1390 S 1100 E Ste 203, Salt Lake City, UT 84105-2463 | 2010-10-25 |
| 1699090472 | Mindy Jo Vanderloo | Counselor | 1390 S 1100 E Ste 203, Salt Lake City, UT 84105-2463 | 2010-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285106237 | Laiyan H Bawadeen | Counselor | 1425 700 E Suite #102, Salt Lake City, UT 84105 | 2018-12-31 |
| 1639644255 | Claire Elizabeth Gray | Marriage & Family Therapist | 1425 700 East, Salt Lake City, UT 84105 | 2018-10-10 |
| 1083089643 | Celisa Packer | Social Worker | 2020 E Lake St, Salt Lake City, UT 84105 | 2015-12-08 |
| 1083052963 | Christina Elizabeth Burton | Nurse Practitioner | 1008 S 1100 E, Apt 6, Salt Lake City, UT 84105 | 2013-06-12 |
| 1649548355 | Leland Burt Cowan | Surgery | 1405 Princeton Ave, Salt Lake City, UT 84105 | 2011-12-08 |
| 1639460355 | Sally Cathleen Webster | Counselor | 1248 Yale Avenue, Salt Lake City, UT 84105 | 2011-04-28 |
| 1912205105 | Melissa Wilson | Case Manager/Care Coordinator | 1522 S 1100 E, Salt Lake City, UT 84105 | 2011-03-11 |
| 1013215789 | Tamara Marie Wright | Counselor | 1996 Lake St, Salt Lake City, UT 84105 | 2011-03-04 |
| 1144527243 | Crystal Nicole Garduno | Counselor | 1522 South 1100 East, Salt Lake City, UT 84105 | 2011-02-25 |
| 1508011180 | Keith Elliott | Anesthesiology | 1552 South 1000 East, Salt Lake City, UT 84105 | 2008-11-24 |
| Find all providers in zip 84105 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790269892 | Center for Healing Therapies | Clinic/Center | 699 N. S. Temple, Suite 201 G, Salt Lake City, UT 84102-4252 | 2018-09-24 |
| 1730661349 | City Center Psychology, Pllc | Clinic/Center | 175 S Main St Ste 530, Salt Lake City, UT 84111-1916 | 2018-08-30 |
| 1649684903 | Child and Family Empowerment Services, LLC | Clinic/Center | 1578 W 1700 S Ste 200, Salt Lake City, UT 84104-3461 | 2014-06-16 |
| 1215215181 | Stein Mann Institute, LLC | Clinic/Center | 10 W Broadway Ste 820, Salt Lake City, UT 84101-2000 | 2011-07-26 |
| 1326159948 | Front Line Services, Inc. | Clinic/Center | 1800 S West Temple, Suite A110, Salt Lake City, UT 84115-1851 | 2006-08-31 |
| 1548239940 | Center for Human Potential Inc | Clinic/Center | 525 E 100 S, Suite 120, Salt Lake City, UT 84102-2070 | 2006-03-16 |
| 1285261016 | Tava Health, Inc | Clinic/Center | 222 E 7th Ave, Salt Lake City, UT 84103-2518 | 2020-03-23 |
| 1952883589 | Susan Curtis, Cmhc, PC | Clinic/Center | 1390 S 1100 E Ste 203, Salt Lake City, UT 84105 | 2018-08-30 |
| 1518466465 | Salt Lake Counseling and Coaching, Pllc | Clinic/Center | 1516 S 1100 E, Salt Lake City, UT 84105-2425 | 2018-02-06 |
| 1417469115 | Soul Growth LLC | Clinic/Center | 1719 S Main St, Salt Lake City, UT 84115-1911 | 2017-11-02 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84105 |
Please comment or provide details below to improve the information on GATEWAY ACADEMY, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.