JORDAN RULLO LLC (NPI# 1881109544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881109544 |
| Entity Type | Organization |
| Organization Name | JORDAN RULLO LLC |
| Practice Address |
1433 S 1100 E Salt Lake City UT 84105-2434 |
| Mailing Address |
2958 S Metropolitan Way Salt Lake City UT 84109-2237 |
| Practice Telephone | 3852024250 |
| Mailing Telephone | 3852024250 |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2017-12-04 |
| Authorized Official Name | DR. JORDAN ELIZABETH RULLO (PSYCHOLOGIST/MANAGER) |
| Authorized Official Telephone | 6129913042 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
UT | Ambulatory Health Care Facilities |
| Street Address |
1433 S 1100 E |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84105-2434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003144684 | Burton Counseling | Community/Behavioral Health | 1433 S 1100 E, Salt Lake City, UT 84105-2434 | 2009-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285106237 | Laiyan H Bawadeen | Counselor | 1425 700 E Suite #102, Salt Lake City, UT 84105 | 2018-12-31 |
| 1639644255 | Claire Elizabeth Gray | Marriage & Family Therapist | 1425 700 East, Salt Lake City, UT 84105 | 2018-10-10 |
| 1083089643 | Celisa Packer | Social Worker | 2020 E Lake St, Salt Lake City, UT 84105 | 2015-12-08 |
| 1083052963 | Christina Elizabeth Burton | Nurse Practitioner | 1008 S 1100 E, Apt 6, Salt Lake City, UT 84105 | 2013-06-12 |
| 1649548355 | Leland Burt Cowan | Surgery | 1405 Princeton Ave, Salt Lake City, UT 84105 | 2011-12-08 |
| 1639460355 | Sally Cathleen Webster | Counselor | 1248 Yale Avenue, Salt Lake City, UT 84105 | 2011-04-28 |
| 1912205105 | Melissa Wilson | Case Manager/Care Coordinator | 1522 S 1100 E, Salt Lake City, UT 84105 | 2011-03-11 |
| 1013215789 | Tamara Marie Wright | Counselor | 1996 Lake St, Salt Lake City, UT 84105 | 2011-03-04 |
| 1144527243 | Crystal Nicole Garduno | Counselor | 1522 South 1100 East, Salt Lake City, UT 84105 | 2011-02-25 |
| 1508011180 | Keith Elliott | Anesthesiology | 1552 South 1000 East, Salt Lake City, UT 84105 | 2008-11-24 |
| Find all providers in zip 84105 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1194223867 | Cottonwood Behavioral Counseling LLC | Clinic/Center | 6337 S Highland Dr # 227 Suite 227, Salt Lake City, UT 84121-8558 | 2018-01-29 |
| 1336533348 | Salt Lake Weight Counseling | Clinic/Center | 7105 S. Highland Dr. Ste 202, Salt Lake City, UT 84121 | 2015-03-27 |
| 1760576698 | Lds Family Services | Clinic/Center | 132 S State St Ste 100, Salt Lake City, UT 84111-1506 | 2006-10-03 |
| 1568084739 | Utah Zion Healing | Clinic/Center | 2870 E 3300 S, Salt Lake City, UT 84109-2821 | 2020-05-11 |
| 1467002253 | Audrey Maya Wadhwani | Clinic/Center | 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2019-09-13 |
| 1922570266 | Ihc Health Services Inc | Clinic/Center | 324 E 10th Ave Ste 178, Salt Lake City, UT 84103-2885 | 2018-12-27 |
| 1023461415 | Alpine Center for Personal Growth | Clinic/Center | 5689 S Redwood Rd, Suite 30, Salt Lake City, UT 84123-5447 | 2016-07-20 |
| 1528413531 | University of Utah Pediatric Behavioral Health Services | Clinic/Center | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2016-04-27 |
| 1821450735 | University of Utah Pediatric Behavioral Health Services | Clinic/Center | 1525 W 2100 S, Salt Lake City, UT 84119-1401 | 2016-03-22 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84105 |
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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.