DR. AMY BONIFAY RUSSELL (NPI# 1275916223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275916223 |
| Entity Type | Individual |
| Full Name | DR. AMY BONIFAY RUSSELL |
| Credential | PSY. D. |
| Practice Address |
2469 E Fort Union Blvd Ste 206 Salt Lake City UT 84121-3417 |
| Mailing Address |
2469 East Fort Union Blvd #206 Slc UT 84121 |
| Practice Telephone | 8013006223 |
| Mailing Telephone | 8013006223 |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2015-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
4802206-2501 | UT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912526674 | Amy Christine Russell | Counselor | 317 30th St Apt 304d, Springfield, OR 97478-7619 | 2020-04-13 |
| 1104291459 | Amy Russell | Social Worker | 1911 E 22nd St, Cheyenne, WY 82001-4142 | 2015-12-10 |
| 1821370263 | Amy M Russell | Pharmacist | 9101 Sun Isle Dr Ne, Saint Petersburg, FL 33702-2617 | 2011-09-12 |
| 1265634638 | Amy D Russell | Dentist | 1651 Mount Vernon Rd, Dunwoody, GA 30338-4264 | 2007-06-05 |
| 1184186397 | Amy Russell | Licensed Practical Nurse | 1100 W 6th Ave, Gary, IN 46402-1711 | 2019-04-05 |
| 1073000832 | Amy Russell | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2018-04-17 |
| 1013415314 | Amy Elizabeth Russell | Nurse Practitioner | 4420 Lake Boone Trl, Raleigh, NC 27607-7505 | 2018-02-01 |
| 1043733199 | Amy Jenniver Russell | Social Worker | 2950 Tennyson St, Denver, CO 80212-3029 | 2017-07-20 |
| 1508226291 | Amy Danielle Russell | Occupational Therapist | 123 Jefferson Davis Blvd, Natchez, MS 39120-5103 | 2016-02-24 |
| 1578986659 | Amy Russell | Nurse Practitioner | 3599 University Blvd S, Jacksonville, FL 32216-4252 | 2014-01-27 |
| Street Address |
2469 E FORT UNION BLVD STE 206 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84121-3417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194380436 | Kelly Seim | Social Worker | 2469 E Fort Union Blvd Ste 206, Salt Lake City, UT 84121-3417 | 2019-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407483522 | Kaitlyn Horne | Behavior Technician | 6910 S. Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-26 |
| 1952936387 | Jared Wells | Behavior Technician | 6910 S Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-05 |
| 1518591874 | Slc Plastic Surgery LLC | Plastic Surgery | 6686 Highland Drive, Cottonwood Heights, UT 84121 | 2020-02-26 |
| 1093273708 | Anna O'hearon | Counselor | New Roads Behavioral Health, 2450 Fort Union Blvd, Cottonwood Heights, UT 84121 | 2019-03-12 |
| 1053883181 | Charles Keller IIi | Pediatrics | 2198 S Yvonne Rd #344, Salt Lake City, UT 84121 | 2018-12-31 |
| 1669964516 | Marissa King | Specialist | 1141 E. 3900 S. Suite 150a, Salt Lake, UT 84121 | 2018-06-05 |
| 1376044313 | Slpd Cottonwood LLC | Dentist | 7167 South Highland Drive, 200, Cottonwood Heights, UT 84121 | 2018-02-26 |
| 1700315462 | Nelson & Tillmann Family Dentistry, PC | Dentist | 5872 S. 900 E. Ste 202, Salt Lake City, UT 84121 | 2017-06-07 |
| 1912430588 | Wasatch Midwifery and Wellness, LLC | Dietitian, Registered | 6440 S Wasatch Blvd, Ste 140, Holladay, UT 84121 | 2017-04-10 |
| 1407308331 | Tina Polgar | Registered Nurse | 6244 Highland Drive, Murray, UT 84121 | 2016-10-26 |
| Find all providers in zip 84121 | ||||
| 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 |
| 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 |
| 1386910909 | Barbara Ogden | Psychologist | 77 W 200 S, Suite 314, Salt Lake City, UT 84101-1609 | 2012-03-28 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84121 |
Please comment or provide details below to improve the information on DR. AMY BONIFAY RUSSELL.
| 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.