ODYSSEY HOUSE OF UTAH (NPI# 1992148779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992148779 |
| Entity Type | Organization |
| Organization Name | ODYSSEY HOUSE OF UTAH |
| Practice Address |
350 E 2100 S Salt Lake City UT 84115-2266 |
| Practice Telephone | 8014283241 |
| Practice Fax Number | 8013224002 |
| Mailing Telephone | 8014283241 |
| Mailing Fax Number | 8013224002 |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2013-04-11 |
| Authorized Official Name | DR. BERRETT BONNELLA (LCSW/INTERN SUPERVISOR) |
| Authorized Official Telephone | 8014283241 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831474170 | Odyssey House of Utah | Substance Abuse Rehabilitation Facility | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2011-10-19 |
| 1174807259 | Odyssey House of Utah | Substance Abuse Rehabilitation Facility | 344 E 100 S, Ste 301, Salt Lake City, UT 84111-1700 | 2011-10-06 |
| 1588985238 | Odyssey House of Utah | Substance Abuse Rehabilitation Facility | 340 E 100 S, Salt Lake City, UT 84111-1702 | 2010-06-17 |
| 1588984280 | Odyssey House of Utah | Substance Abuse Rehabilitation Facility | 68 S 600 E, Slc, UT 84102-1007 | 2010-06-03 |
| 1356669550 | Odyssey House of Utah | Foster Care Agency | 344 E 100 S, Suite 301, Salt Lake City, UT 84111-1700 | 2010-05-12 |
| Street Address |
350 E 2100 S |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84115-2266 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629388202 | Theresa Rose Oconnor | Counselor | 350 E 2100 S, Salt Lake City, UT 84115-2266 | 2010-10-15 |
| 1790307668 | Brenda Colledge | Case Manager/Care Coordinator | 350 E 2100 S, Salt Lake City, UT 84115-2266 | 2020-05-13 |
| 1447753371 | Victoria Elizabeth Hayes | Case Manager/Care Coordinator | 350 E 2100 S, Salt Lake City, UT 84115-2266 | 2018-03-16 |
| 1336665330 | Rachel Ann Carter | Social Worker | 350 E 2100 S, Salt Lake City, UT 84115-2266 | 2017-08-21 |
| 1992151641 | Elizabeth Coates | Student in an Organized Health Care Education/Training Program | 350 E 2100 S, Salt Lake City, UT 84115-2266 | 2016-05-12 |
| 1700248341 | Mccall Peterson | Student in an Organized Health Care Education/Training Program | 350 E 2100 S, Salt Lake City, UT 84115-2266 | 2016-03-23 |
| 1871958686 | Jenny Ann Dunn | Student in an Organized Health Care Education/Training Program | 350 E 2100 S, Salt Lake City, UT 84115-2266 | 2015-12-21 |
| 1649645896 | Karson Applin | Student in an Organized Health Care Education/Training Program | 350 E 2100 S, Salt Lake City, UT 84115-2266 | 2015-12-13 |
| 1013391366 | Kristina Oakley | Student in an Organized Health Care Education/Training Program | 350 E 2100 S, Salt Lake City, UT 84115-2266 | 2015-07-16 |
| 1043698293 | Jennifer Franco | Counselor | 350 E 2100 S, Salt Lake City, UT 84115-2266 | 2015-05-08 |
| Find all providers in the same location | ||||
| 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 | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639789464 | Enduring Connections Counseling Services LLC | Community/Behavioral Health | 4659 S Highland Dr, Salt Lake City, UT 84117-5137 | 2020-08-06 |
| 1033733001 | Jessica Jo Pllc | Community/Behavioral Health | 3527 S 1200 E, Salt Lake City, UT 84106-2425 | 2020-06-04 |
| 1467071407 | Cancer Wellness House, Inc. | Community/Behavioral Health | 59 S 1100 E, Salt Lake City, UT 84102-1508 | 2020-04-09 |
| 1942859707 | Madre Tierra Counseling & Consulting LLC | Community/Behavioral Health | 3763 S Secord St, Salt Lake City, UT 84115-4771 | 2019-09-05 |
| 1295389708 | Peaceful Solutions Counseling LLC | Community/Behavioral Health | 1399 S 700 E Ste 5, Salt Lake City, UT 84105-2161 | 2019-08-01 |
| 1689139198 | Mmtc | Community/Behavioral Health | 1411 W 1100 N, Salt Lake City, UT 84116-1634 | 2019-02-08 |
| 1891274429 | Crystal Tina Marie Amezquita | Community/Behavioral Health | 1141 E 3900 S Ste A150, Salt Lake City, UT 84124-1215 | 2018-08-14 |
| 1558840611 | Noble Soul Therapy | Community/Behavioral Health | 699 E South Temple # 300a, Salt Lake City, UT 84102-1142 | 2018-08-09 |
| 1932631116 | Mattison Therapeutic Consulting and Counseling | Community/Behavioral Health | 667 E Redondo Ave, Salt Lake City, UT 84105-3028 | 2017-03-28 |
| 1396281218 | Pat Brehl Lcsw LLC | Community/Behavioral Health | 439 E 900 S, Salt Lake City, UT 84111-4303 | 2017-01-17 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84115 |
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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.