KELLY KONOPACKI


Address: 501 Chipeta Way, Salt Lake City, UT 84108
Phone: 8015873143

KELLY KONOPACKI (NPI# 1912362591) 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) 1912362591
Entity Type Individual
Full Name KELLY KONOPACKI
Credential PHD
Practice Address 501 Chipeta Way
Salt Lake City
UT 84108
Mailing Address 501 S Chipeta Way
Salt Lake City
UT 84108-1222
Practice Telephone 8015873143
Mailing Telephone 6507395434
Enumeration Date 2015-12-23
Last Update Date 2018-07-18
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103G00000X Clinical Neuropsychologist 10299168-2501 UT Behavioral Health & Social Service Providers

Office Location

Street Address 501 CHIPETA WAY
City SALT LAKE CITY
State UT
Zip Code 84108

Providers in the same location

NPI Name Taxonomy Address Enumeration
1245220805 Robert D Birch Psychiatry & Neurology 501 Chipeta Way, Suite 1214, Salt Lake City, UT 84108-0108 2005-10-25
1093327140 Joshua Morris Psychologist 501 Chipeta Way, Salt Lake City, UT 84108 2020-08-19
1073141925 Rachel Niezrecki Student in an Organized Health Care Education/Training Program 501 Chipeta Way, Salt Lake City, UT 84108 2020-03-27
1831621333 Heiko Weert De Riese Psychiatry & Neurology 501 Chipeta Way, Rm. 1885, Salt Lake City, UT 84108 2017-04-03
1174978811 Brittany Mccolgan Psychiatry & Neurology 501 Chipeta Way, University of Utah Psychiatry Department, Salt Lake City, UT 84108 2016-05-02
1912388463 Alison Lafollette Psychologist 501 Chipeta Way, Salt Lake City, UT 84108-1222 2015-06-10
1366829004 Sean Patrick Ferrell Psychiatry & Neurology 501 Chipeta Way, Salt Lake City, UT 84108 2015-05-01
1932471471 Robert D Birch Do PC Psychiatry & Neurology 501 Chipeta Way, Suite 1214, Salt Lake City, UT 84108-1222 2012-01-30
1487922670 Laurian Escalanti Social Worker 501 Chipeta Way, University Neuropsychiatric Institute, Salt Lake City, UT 84108-1222 2011-12-02
1184918609 Jennifer Rounds Social Worker 501 Chipeta Way, Salt Lake City, UT 84108 2011-06-01
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548753056 Maxine Ht Erickson Assistant Behavior Analyst 780 Guardsman Way, Salt Lake City, Ut 84108, Salt Lake City, USA 84108 2018-06-08
1841704061 Robyn Carver Occupational Therapist 421 Wakara Wat, Salt Lake City, UT 84108 2017-11-27
1518478742 Lcr Dental Sugar House Dentist 2068 S 2100 E Suite #a, Salt Lake City, UT 84108 2017-10-16
1447708912 Aubrianne Squire Evans Occupational Therapist 421 S Wakara Way Ste 201, Salt Lake City, UT 84108 2016-09-14
1629524426 Ryan Weisenbeck Specialist/Technologist 580 S Guardsman Way, Salt Lake City, UT 84108 2016-08-31
1164885547 Michael Fazzone Student in an Organized Health Care Education/Training Program 530 South Wakara Way, University of Urah, School of Dentistry, Salt Lake City, UT 84108 2016-04-01
1669833489 Bryon Claflin Registered Nurse 650 S Komas Ste 200, Salt Lake City, UT 84108 2016-03-08
1801283833 Autism Assement Treatment Program Adult Psychologist 650 S Komas, Suite 200, Salt Lake City, UT 84108 2015-04-16
1578993275 Matthew and David Dental Pllc Dentist 1355 Foothill Drive, Salt Lake City, UT 84108 2013-11-15
1841631520 Deepika Garg Internal Medicine 675 S Arapeen Dr Ste 205, Salt Lake City, UT 84108 2013-07-10
Find all providers in zip 84108

Taxonomy Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning.
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1770954356 Erin Elizabeth Krauskopf Clinical Neuropsychologist 231 E 400 S Ste 335, Salt Lake City, UT 84111-2806 2015-10-08
1528469947 Jordan Harris Rigby Clinical Neuropsychologist 230 S 500 E Ste 100, Salt Lake City, UT 84102-2048 2014-09-05
1154565729 Keith Mcgoldrick Clinical Neuropsychologist 1733 S 1100 E Ste 102, Salt Lake City, UT 84105-3482 2009-04-27
1356593297 Dustin Bradshaw Hammers Clinical Neuropsychologist 650 Komas Dr Ste 106a, Salt Lake City, UT 84108-1225 2008-10-22
1770612863 Elaine Clark Clinical Neuropsychologist 501 Chipita Way, Univ of Utah Neuropsychiatric Institute, Salt Lake City, UT 84108 2007-03-05
1245251776 Kelly D Garrett Clinical Neuropsychologist 333 South 900 East, Salt Lake City, UT 84102-2310 2006-07-21
1831150374 Juan A. Mejia Clinical Neuropsychologist 327 Denver St, Salt Lake City, UT 84111-3002 2006-03-31
1295720969 Kevin Duff Clinical Neuropsychologist 650 Komas Dr, 106a, Salt Lake City, UT 84108-1215 2005-09-19
1518453406 Joseph Un Kim Clinical Neuropsychologist 501 S Chipeta Way, Salt Lake City, UT 84108-1222 2018-07-03
1922394220 Jeremy J Davis Clinical Neuropsychologist 30 N 1900 E, 1r55, Salt Lake City, UT 84132-0002 2011-06-24
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Competitor

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City SALT LAKE CITY
Zip Code 84108

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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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