MATTHEW V WENNER (NPI# 1760409486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760409486 |
| Entity Type | Individual |
| Full Name | MATTHEW V WENNER |
| Credential | PHD |
| Practice Address |
1225 Fort Union Blvd Ste 215 Midvale UT 84047-1882 |
| Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
| Practice Telephone | 8015014350 |
| Mailing Telephone | 8015014350 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2007-10-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 2764342501 | UT | Behavioral Health & Social Service Providers |
| Street Address |
1225 FORT UNION BLVD STE 215 |
| City | MIDVALE |
| State | UT |
| Zip Code | 84047-1882 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992722680 | K Scott Dransfield | Social Worker | 1225 Fort Union Blvd Ste 215, Midvale, UT 84047-1882 | 2006-07-17 |
| 1336160696 | Margie O Erickson | Social Worker | 1225 Fort Union Blvd Ste 215, Midvale, UT 84047-1882 | 2006-07-22 |
| 1902827462 | Richard A Segal | Psychiatry & Neurology | 1225 Fort Union Blvd Ste 215, Midvale, UT 84047-1882 | 2006-07-21 |
| 1720009285 | Sandra Deirdre Ehninger | Social Worker | 1225 Fort Union Blvd Ste 215, Midvale, UT 84047-1882 | 2006-07-21 |
| 1184645624 | Bryan S Maulden | Psychiatry & Neurology | 1225 Fort Union Blvd Ste 215, Midvale, UT 84047-1882 | 2006-07-21 |
| 1437176146 | Lisa L Boice | Social Worker | 1225 Fort Union Blvd Ste 215, Midvale, UT 84047-1882 | 2006-07-17 |
| 1851318570 | Jody L Penrod | Nurse Practitioner | 1225 Fort Union Blvd Ste 215, Midvale, UT 84047-1882 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649885096 | Wound Pros Utah | Durable Medical Equipment & Medical Supplies | 6975 Union Park Avenue, Suite 600, Cottonwood Heights, UT 84047 | 2020-09-12 |
| 1457965824 | Duy Danny Vo | Pharmacist | 7200 S State St, Midvale, UT 84047 | 2020-09-03 |
| 1619457314 | Tlcpo LLC | Counselor | 6975 Union Park Avenue Suite 600, Cottonwood Heights, UT 84047 | 2018-08-21 |
| 1700371606 | Heather Ivana Lawrence | Social Worker | 6856 700 E, Midvale, Ut 84047, Midvale,ut, UT 84047 | 2018-06-25 |
| 1285128942 | A&a Counseling | Counselor | 7602 S Main St, Midvale, UT 84047 | 2018-06-17 |
| 1396235339 | Hhalmid | Assisted Living Facility | 6968 S 700 E, Midvale, UT 84047 | 2018-05-15 |
| 1750879987 | Rosemarie Elaine Brinig | Counselor | 75 E. Ft. Union, C118, Midvale, UT 84047 | 2018-04-24 |
| 1861921140 | Olivia Devenport | Behavior Technician | 7434 S State Street, Midvale, UT 84047 | 2017-06-08 |
| 1376083071 | Marathon Health, LLC | Nurse Practitioner | 7259 South Bingham Junction, C/o Chg- Ut Health Center, Midvale, UT 84047 | 2017-02-28 |
| 1710436316 | Michael Naanes | Physical Therapist | 900 East 6900 South, Suite 100, Midvale, UT 84047 | 2016-09-25 |
| Find all providers in zip 84047 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
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| 1043776933 | Jennie Lyn Bingham | Psychologist | 750 Round Valley Dr Ste 204, Park City, UT 84060-7549 | 2019-02-15 |
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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.