SOUTH VALLEY FAMILY WELLNESS (NPI# 1306484886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306484886 |
| Entity Type | Organization |
| Organization Name | SOUTH VALLEY FAMILY WELLNESS |
| Practice Address |
1309 W South Jordan Pkwy Ste 210 South Jordan UT 84095-9002 |
| Practice Telephone | 8013355378 |
| Mailing Telephone | 8013355378 |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2019-12-16 |
| Authorized Official Name | DR. JACOB GIBSON (OWNER) |
| Authorized Official Telephone | 8013012450 |
| Authorized Official Credential | PHD, LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
1309 W SOUTH JORDAN PKWY STE 210 |
| City | SOUTH JORDAN |
| State | UT |
| Zip Code | 84095-9002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194084269 | Allyce Katie Jones | Nurse Practitioner | 1309 W South Jordan Pkwy Ste 210, South Jordan, UT 84095 | 2012-05-10 |
| 1194133603 | Lexie Daley | Marriage & Family Therapist | 1309 W South Jordan Pkwy Ste 210, South Jordan, UT 84095-9002 | 2014-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033745393 | Beverly Laraine Williams | Social Worker | 11260 S River Heights Drive, South Jordan, UT 84095 | 2020-03-19 |
| 1265902902 | Sarah Richele Kelley | Specialist/Technologist | 10236 Alder Grovey Way, South Jordan, UT 84095 | 2018-11-26 |
| 1326528837 | Kristi Couse | Massage Therapist | 10679 S 2200 W Apt 2, South Jordan, UT 84095 | 2018-08-15 |
| 1821516063 | River Crossing Dental Professional Corporation | Clinic/Center | 12427 South 4000 West, Suite #200, Riverton, UT 84095 | 2017-09-08 |
| 1245755719 | Staci Stout | Dental Hygienist | 3113 W Swiss Pass Cir, South Jordan, UT 84095 | 2017-08-07 |
| 1437698750 | Ryan Sears | Dentist | 10894 So. River Front Parkway, South Jordan, UT 84095 | 2017-02-20 |
| 1366989931 | Ultimate Sports Regenerative Medicine | Chiropractor | 1098 W. South Jordan Pkwy, Suite 101, South Jordan, UT 84095 | 2017-01-20 |
| 1306393889 | Tal Quirl | Optometrist | 3571 W. 10400 S., South Jordan, UT 84095 | 2016-09-01 |
| 1023562667 | Sevon Taroian | Social Worker | 11260 River Heights Drive, South Jordan, UT 84095 | 2016-08-11 |
| 1952762932 | Megan Buckley | Developmental Therapist | 881 Baxter Drive, Ste 100, South Jordan, UT 84095 | 2016-03-17 |
| Find all providers in zip 84095 | ||||
| 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 |
|---|---|---|---|---|
| 1033744776 | Rising Summits | Clinic/Center | 11293 S Morning Tide Ln, South Jordan, UT 84009-5022 | 2020-03-03 |
| 1942772801 | Tradewinds Counseling | Clinic/Center | 2651 W South Jordan Pkwy # 101d, South Jordan, UT 84095-8953 | 2018-12-17 |
| 1700439460 | The Healing Journey Therapy Center | Clinic/Center | 885 W Baxter Dr, South Jordan, UT 84095-8506 | 2019-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043810047 | Ora Counseling | Clinic/Center | 115 Golf Course Rd Ste A, Logan, UT 84321-5951 | 2020-10-28 |
| 1447899570 | First Choice Healing LLC | Clinic/Center | 1045 S Orem Blvd, Orem, UT 84058-6979 | 2020-01-06 |
| 1144868100 | Vive Care, LLC | Clinic/Center | 120 W 1470 S Ste A, Saint George, UT 84770-6798 | 2019-12-20 |
| 1851939250 | Imagine Counseling Services | Clinic/Center | 5663 S Redwood Rd Unit 2, Taylorsville, UT 84123-5449 | 2019-12-16 |
| 1811548589 | Insaneability | Clinic/Center | 2013 E Fielding Hill Ln, Draper, UT 84020-2505 | 2019-09-24 |
| 1083264907 | Hobble Creek Behavoral Health | Clinic/Center | 1291 Expressway Ln # L, Spanish Fork, UT 84660-1333 | 2019-09-12 |
| 1407403983 | Haven Recovery LLC | Clinic/Center | 1474 W 2100 N, Pleasant Grove, UT 84062-9508 | 2019-08-20 |
| 1386299287 | Intermountain Counseling Center | Clinic/Center | 35 N Main Street, Suite 200 B, Spring City, UT 84662 | 2019-08-07 |
| 1710532619 | Solstone, LLC | Clinic/Center | 1353 N 1075 W Ste 204, Farmington, UT 84025-2772 | 2019-08-07 |
| 1275091407 | Taylor and Taylor Consulting | Clinic/Center | 459 N 300 W Ste 13, Kaysville, UT 84037-4204 | 2019-03-06 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH JORDAN |
| Zip Code | 84095 |
Please comment or provide details below to improve the information on SOUTH VALLEY FAMILY WELLNESS.
| 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.