DR. KATHERINE THOMAS FORTENBERRY (NPI# 1982902185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982902185 |
| Entity Type | Individual |
| Full Name | DR. KATHERINE THOMAS FORTENBERRY |
| Credential | PH.D. |
| Practice Address |
375 Chipeta Way Suite A Salt Lake City UT 84108-1260 |
| Practice Telephone | 8015873379 |
| Mailing Telephone | 8015873379 |
| Enumeration Date | 2011-03-11 |
| Last Update Date | 2012-02-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
8106647-2501 | UT | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
50871 | MS | Behavioral Health & Social Service Providers |
| N | 103TH0004X |
Psychologist Specialization: Health |
8106647-2501 | UT | Behavioral Health & Social Service Providers |
| N | 103TH0004X |
Psychologist Specialization: Health |
50871 | MS | Behavioral Health & Social Service Providers |
| Street Address |
375 CHIPETA WAY SUITE A |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84108-1260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154380533 | Leonard Jared Haas | Psychologist | 375 Chipeta Way, Suite A, Salt Lake City, UT 84108-1260 | 2006-03-22 |
| 1659900132 | Katie Myrick | Student in an Organized Health Care Education/Training Program | 375 Chipeta Way, Ste A, Salt Lake City, UT 84108-1261 | 2020-04-06 |
| 1487913497 | Arazu Sigari Wanna | Student in an Organized Health Care Education/Training Program | 375 Chipeta Way, Suite A, Salt Lake City, UT 84108-1260 | 2012-05-10 |
| 1689966004 | Saskia Spiess | Family Medicine | 375 Chipeta Way, Suite A, Salt Lake City, UT 84108-1260 | 2011-05-03 |
| 1235429655 | Georgia Blackwood Kubic | Family Medicine | 375 Chipeta Way, University of Utah Family Medicine Residency, Salt Lake City, UT 84108-1260 | 2011-04-19 |
| 1598919060 | Clarence Richard Henriksen IIi | Family Medicine | 375 Chipeta Way, Ste A, Salt Lake City, UT 84132-0001 | 2008-11-11 |
| 1841233749 | Christopher Jones | Psychiatry & Neurology | 375 Chipeta Way, Suite 200a, Salt Lake City, UT 84108-1260 | 2006-06-14 |
| 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 Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780230433 | Carolynne Elizabeth Baron | Psychologist | Va Salt Lake City Healthcare System 500 Foothill Drive, Salt Lake City, UT 84148-0001 | 2019-08-16 |
| 1083133938 | Dio Turner II | Psychologist | 1060 E 100 S Ste 100, Salt Lake City, UT 84102-1582 | 2017-09-12 |
| 1366965618 | Ashley Stuart | Psychologist | 44 North Mario Capecchi Drive, Salt Lake City, UT 84113 | 2017-07-19 |
| 1205202355 | Laura Rowley | Psychologist | 170 S 1000 E Ste 201, Salt Lake City, UT 84102-1403 | 2015-08-12 |
| 1275916223 | Amy Bonifay Russell | Psychologist | 2469 E Fort Union Blvd Ste 206, Salt Lake City, UT 84121-3417 | 2015-07-08 |
| 1952710071 | The Pearce Institute of Child and Family Psychology, LLC | Psychologist | 231 E 2100 S, Suite 203, Salt Lake City, UT 84115-2187 | 2014-08-04 |
| 1053728105 | Margaret Ruth Moore | Psychologist | 1726 E Michigan Ave, Salt Lake City, UT 84108-1320 | 2014-07-21 |
| 1316360225 | Amanda Lorraine Rapacz | Psychologist | 239 E Belmont Ave, Salt Lake City, UT 84111-4619 | 2014-01-28 |
| 1134566904 | Allison Marie Smith | Psychologist | 504 E 800 S Apt 1b, Salt Lake City, UT 84102-3361 | 2013-06-03 |
| 1558611970 | New Life Balance, LLC | Psychologist | 2689 S Highland Dr, Salt Lake City, UT 84106-2774 | 2012-09-13 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84108 |
Please comment or provide details below to improve the information on DR. KATHERINE THOMAS FORTENBERRY.
| 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.