AUTHENTICITY UTAH PLLC (NPI# 1477175560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477175560 |
| Entity Type | Organization |
| Organization Name | AUTHENTICITY UTAH PLLC |
| Practice Address |
2265 S State St Apt 272 South Salt Lake UT 84115-1405 |
| Practice Telephone | 4357208338 |
| Mailing Telephone | 4357208338 |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2020-05-11 |
| Authorized Official Name | PETER BRYAN CONDER (FOUNDER) |
| Authorized Official Telephone | 4357208338 |
| Authorized Official Credential | LCMHC |
| 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 |
2265 S STATE ST APT 272 |
| City | SOUTH SALT LAKE |
| State | UT |
| Zip Code | 84115-1405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710367610 | Peter Bryan Conder | Counselor | 2265 S State St Apt 272, South Salt Lake, UT 84115-1405 | 2015-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344198 | Shannon Ballinger | Clinic/Center | 1470 400 W, Salt Lake City, UT 84115 | 2020-10-22 |
| 1992346704 | Anicka Inc | Clinic/Center | 3195 South Main St, Ste 260, South Salt Lake, UT 84115 | 2019-10-02 |
| 1083177505 | Vitor Gabriel Giuliani Alcantara Carioca | Specialist/Technologist | 1850 South Campus Drive, Salt Lake City, UT 84115 | 2019-04-11 |
| 1427528371 | Samuel James Leonhart | Behavior Technician | 354 East Coatsville Drive, Salt Lake City, UT 84115 | 2018-12-04 |
| 1093228645 | Eco Pharmacy LLC | Pharmacy | 3702 S State Street Suite 115, South Salt Lake City, UT 84115 | 2017-11-06 |
| 1568973055 | Eco Apothecary LLC | Pharmacy | 3701 S State Street Suite 114, South Salt Lake City, UT 84115 | 2017-10-24 |
| 1548780455 | Kelly Lund | Case Manager/Care Coordinator | 447 W. Bearcat Dr., Salt Lake City, UT 84115 | 2017-06-21 |
| 1104271238 | The Church of Philadelphia Inc. | Community/Behavioral Health | 2358 South Main Street, Salt Lake City, UT 84115 | 2016-04-26 |
| 1710368626 | Jennifer Swanhild Edwards | Counselor | 140 W 2100 S Ste 244, Salt Lake City, UT 84115 | 2015-06-16 |
| 1508247065 | John Mcguire | Health Educator | 1370 S. West Temple, Salt Lake City, UT 84115 | 2015-06-10 |
| Find all providers in zip 84115 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 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 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH SALT LAKE |
| Zip Code | 84115 |
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| 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.