KELSEY MARIE WISS (NPI# 1366946261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366946261 |
| Entity Type | Individual |
| Full Name | KELSEY MARIE WISS |
| Practice Address |
3809 W 6200 S Taylorsville UT 84129-3725 |
| Mailing Address |
4460 S Highland Dr Salt Lake City UT 84124-3543 |
| Practice Telephone | 8019634317 |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-03-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Street Address |
3809 W 6200 S |
| City | TAYLORSVILLE |
| State | UT |
| Zip Code | 84129-3725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871575472 | Elizabeth Joy Albertsen | Psychologist | 3809 W 6200 S, Taylorsville, UT 84129-3725 | 2005-11-18 |
| 1982178760 | Yahia N/a Iarochen | Community Health Worker | 3809 W 6200 S, Taylorsville, UT 84129-3725 | 2019-01-15 |
| 1871066266 | Jeffery Lyle Summers | Community Health Worker | 3809 W 6200 S, Taylorsville, UT 84129-3725 | 2019-01-08 |
| 1124598651 | Chad Knight | Counselor | 3809 W 6200 S, Taylorsville, UT 84129-3725 | 2018-11-27 |
| 1558846808 | Eduardo Andres Frasqueri | Case Manager/Care Coordinator | 3809 W 6200 S, Taylorsville, UT 84129-3725 | 2018-10-02 |
| 1972088029 | Delsie Anne Bruehl | Community Health Worker | 3809 W 6200 S, Taylorsville, UT 84129-3725 | 2018-09-25 |
| 1760966592 | Shayanne Elizabeth Rodriguez | Case Manager/Care Coordinator | 3809 W 6200 S, Taylorsville, UT 84129-3725 | 2018-09-18 |
| 1700369238 | Amanda Jo Glenn | Case Manager/Care Coordinator | 3809 W 6200 S, Taylorsville, UT 84129-3725 | 2018-09-11 |
| 1164905691 | Teresa Elizabeth Vazquez | Behavior Technician | 3809 W 6200 S, Taylorsville, UT 84129-3725 | 2018-09-11 |
| 1700369246 | Kelsey Tyson | Counselor | 3809 W 6200 S, Taylorsville, UT 84129-3725 | 2018-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891140331 | Caring for Kearns | Social Worker | 5525 S 4015 W, Suite #207 A & B, Taylorsville, UT 84129 | 2016-05-03 |
| 1386014116 | Rusty Scott Burns | Physician Assistant | 4745 South 3200 West, Oquirrh View Clinic, Taylorsville, UT 84129 | 2015-10-06 |
| 1013398817 | Clifford Simpson | Counselor | 4897 S Avant Cir, Taylorsville, UT 84129 | 2015-06-17 |
| 1912328576 | Heather Jenkins | Substance Abuse Rehabilitation Facility | 6200 South 3809 West, Kearns, UT 84129 | 2013-12-30 |
| 1184981201 | Intermountain Community Supports and Services, LLC | In Home Supportive Care | 5104 Heritage Cove, Taylorsville, UT 84129 | 2012-04-13 |
| 1093039521 | Chad Alan Spain | Family Medicine | 3745 West 4700 South, Family Practice, Taylorsville, UT 84129 | 2010-03-26 |
| 1396068342 | Lindsay Helena Wilson | Dermatology | 3845 West 4700 South, Intermountain Healthcare Taylorsville Clinic, Taylorsville, UT 84129 | 2010-03-04 |
| 1962962407 | Craig J Campbell Dpm PC | Durable Medical Equipment & Medical Supplies | 5255 S 4015 W, #140, Salt Lake City, UT 84129 | 2019-03-21 |
| 1851866735 | Katie Nicholls | Physician Assistant | 4745 S 3200 W, Taylorsville, UT 84129 | 2018-10-08 |
| 1962829374 | Spencer Tingey | Family Medicine | 3730 W 4700 S, Taylorsville, UT 84129 | 2014-03-24 |
| Find all providers in zip 84129 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255943569 | Skull Valley Health Care | Clinic/Center | 1929 N Aaron Dr, Tooele, UT 84074-8112 | 2020-08-18 |
| 1003427923 | Painted Desert Recovery LLC | Clinic/Center | 1947 S 2800 E, New Harmony, UT 84757-5115 | 2020-08-13 |
| 1437780673 | Beecon Recovery | Clinic/Center | 60 S Main St Ste B0001, Brigham City, UT 84302-6795 | 2020-01-27 |
| 1124666870 | One Voice Recovery | Clinic/Center | 1400 S 1100 E, Salt Lake City, UT 84105-2435 | 2019-12-12 |
| 1992343834 | Avante Recovery Center, LLC | Clinic/Center | 848 E 1475 N, Lehi, UT 84043-3568 | 2019-12-11 |
| 1467912139 | Infinite Arches LLC | Clinic/Center | 136 25th St, Ogden, UT 84401-1302 | 2019-03-20 |
| 1669952958 | Utah Harm Reduction Coalition | Clinic/Center | 91 E 7200 S, Midvale, UT 84047-1531 | 2018-08-16 |
| 1871016840 | Breakaway Recovery Center Murray, LLC | Clinic/Center | 5296 S Commerce Dr Ste 204, Murray, UT 84107-5393 | 2017-07-21 |
| 1528580180 | Brighton House LLC | Clinic/Center | 2945 E Robidoux Rd, Sandy, UT 84093-1128 | 2017-07-14 |
| 1316392897 | Nuway Recovery, LLC | Clinic/Center | 4925 S 900 E, Salt Lake City, UT 84117-5784 | 2016-05-03 |
| Find all providers with the same taxonomy | ||||
| City | TAYLORSVILLE |
| Zip Code | 84129 |
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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.