SITTI SUHARDI (NPI# 1780281519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780281519 |
| Entity Type | Individual |
| Full Name | SITTI SUHARDI |
| Practice Address |
2550 S Main St Apt 1307 Salt Lake City UT 84115-3071 |
| Practice Telephone | 3235402637 |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2020-10-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | DRIVER'S LICENSE | 212014849 | 01 |
| Street Address |
2550 S MAIN ST APT 1307 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84115-3071 |
| 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 | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801400015 | Tyra Mae Vance | Counselor | 3375 S 880 E, Salt Lake City, UT 84106 | 2020-09-04 |
| 1033721394 | Salt Lake Therapy Collective | Counselor | 311 S 900 E Ste 103, Salt Lake City, UT 84102-2491 | 2020-08-18 |
| 1083172704 | Brooke Pyper | Counselor | 335 W Bugatti Dr, Salt Lake City, UT 84115-2521 | 2019-03-12 |
| 1881168185 | Korilynn Cheatham Bartley | Counselor | 124 S 400 E Ste 300, Salt Lake City, UT 84111-5307 | 2019-01-20 |
| 1164910089 | Gerald Louis Costley | Counselor | 339 E 3900 S Ste 155, Salt Lake City, UT 84107-1978 | 2018-04-26 |
| 1912412867 | Jackson Patrick Collins | Counselor | 1650 E 6670 S, Salt Lake City, UT 84121-2760 | 2017-12-13 |
| 1891225678 | Phil Edward Francis | Counselor | 4000 S 700 E Ste 9, Salt Lake City, UT 84107-2581 | 2017-06-14 |
| 1063866549 | Dustin Palmer | Counselor | 344 E 100 S # 230, Salt Lake City, UT 84111 | 2016-04-20 |
| 1740642735 | Misty Tae Ungricht | Counselor | 4460 S Highland Dr Ste 2106b, Salt Lake City, UT 84124-3543 | 2016-03-28 |
| 1033581723 | Christopher Lee Fiagle | Counselor | 2100 S State Street, S2-300, Salt Lake City, UT 84114-4575 | 2015-10-21 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84115 |
Please comment or provide details below to improve the information on SITTI SUHARDI.
| 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.