REALIGN PSYCHOLOGY LLC


Address: 1042 E Fort Union Blvd, #1085, Midvale, UT 84047-1800
Phone: 8013828702

REALIGN PSYCHOLOGY LLC (NPI# 1467073833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1467073833
Entity Type Organization
Organization Name REALIGN PSYCHOLOGY LLC
Practice Address 1042 E Fort Union Blvd
#1085
Midvale
UT 84047-1800
Mailing Address 1258 Piper Ln
Eugene
OR 97401-1868
Practice Telephone 8013828702
Mailing Telephone 2404788892
Enumeration Date 2020-04-27
Last Update Date 2020-04-27
Authorized Official Name DR. MELISSA ELLSWORTH (CLINICAL PSYCHOLOGIST)
Authorized Official Telephone 2404788892
Authorized Official Credential PHD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
Behavioral Health & Social Service Providers

Office Location

Street Address 1042 E FORT UNION BLVD
#1085
City MIDVALE
State UT
Zip Code 84047-1800

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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1447382494 Victoria D Burgess Psychologist 963 E 7400 S, #304, Midvale, UT 84047-5678 2007-03-12
1235100413 Gail Joanne Liese Psychologist 7309 S 180 W, Midvale, UT 84047-1020 2006-01-27
1497725055 Robert Kenneth Strachan Psychologist 7434 S State St, Midvale, UT 84047-2014 2006-01-25

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NPI Name Taxonomy Address Enumeration
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Competitor

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City MIDVALE
Zip Code 84047

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Dataset Information

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.

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