MS. CLAIRE FRANCES DELISE (NPI# 1568008258) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1568008258 |
Entity Type | Individual |
Full Name | MS. CLAIRE FRANCES DELISE |
Credential | ACMHC |
Practice Address |
11706 S 700 E Draper UT 84020-9365 |
Mailing Address |
12077 S Orchard Oaks Ln Apt 208 Draper UT 84020-5222 |
Practice Telephone | 8015532436 |
Mailing Telephone | 9169904405 |
Enumeration Date | 2019-11-18 |
Last Update Date | 2019-11-18 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 11077067-6009 | UT | Residential Treatment Facilities |
Street Address |
11706 S 700 E |
City | DRAPER |
State | UT |
Zip Code | 84020-9365 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124096417 | Raeanna Kirk | Registered Nurse | 11706 S 700 E, Draper, UT 84020-9365 | 2006-03-10 |
1952940421 | David D Borba | Social Worker | 11706 S 700 E, Draper, UT 84020-9365 | 2020-01-02 |
1841837457 | Emily Faber | Social Worker | 11706 S 700 E, Draper, UT 84020-9365 | 2019-12-02 |
1912165614 | Gateway Academy LLC Draper | Psychiatric Residential Treatment Facility | 11706 S 700 E, Draper, UT 84020-9365 | 2008-05-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194322776 | Chase Larsen Dmd Pllc | Dentist | 723 E 12200 S, Draper, UT 84020 | 2020-10-06 |
1780222380 | Derek Cragun | Counselor | 11706 700 E, Draper, UT 84020 | 2019-12-13 |
1720629371 | Own My Health Medical | Clinic/Center | 12371 900 E, Suite 102, Draper, UT 84020 | 2019-10-04 |
1508418856 | Thomas Mifflin | Physician Assistant | 721 East 12200 South, Draper, UT 84020 | 2019-07-16 |
1124670872 | Necia Dalley | Registered Nurse | 11800 S State St, Draper, UT 84020 | 2019-07-12 |
1285100784 | Tracey M Williams | Psychologist | 13200 S 1601 E, Draper, UT 84020 | 2018-10-23 |
1275008328 | Amoni Paeahelotu Finau | Community Health Worker | 13703 Wheatfield Way, Draper, UT 84020 | 2018-10-04 |
1891275525 | Cynthia Mae Bolton | Psychologist | 1192 E Draper Parkway # 447, Draper, UT 84020 | 2018-08-21 |
1164908026 | Headin' Home Inc. | Community/Behavioral Health | 12300 S. 150 W., Draper, UT 84020 | 2018-07-13 |
1366932576 | Forest Hulet | Dentist | 219 E 12300, Ste I-5, Draper, UT 84020 | 2018-05-14 |
Find all providers in zip 84020 |
Taxonomy Code | 322D00000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Emotionally Disturbed Children |
A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720456981 | Gateway Academy, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 941 E Cattail Dr, Draper, UT 84020-8583 | 2015-09-04 |
1730409517 | Taunya Lyn Wilson | Residential Treatment Facility, Emotionally Disturbed Children | 13073 Wheatfield Way, Draper, UT 84020-9253 | 2010-06-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063013167 | Elevated Youth Services | Residential Treatment Facility, Emotionally Disturbed Children | 10928 S Eureka Dune Dr, South Jordan, UT 84009-4173 | 2020-11-04 |
1003430133 | Cascade Academy | Residential Treatment Facility, Emotionally Disturbed Children | 430 W 200 N, Midway, UT 84049 | 2020-06-04 |
1659900835 | Change Academy At Lake of The Ozarks | Residential Treatment Facility, Emotionally Disturbed Children | 266 South Left Fork Hobble Creek Canyon Road, Springville, UT 84663 | 2020-04-08 |
1083107320 | Red Circle Lodge, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 930 N Memorial St, Hildale, UT 84784 | 2018-06-12 |
1023560679 | Meridian Mentoring | Residential Treatment Facility, Emotionally Disturbed Children | 635 South Main St., Orangeville, UT 84537 | 2016-10-31 |
1033592290 | Keystone Family Support, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2558 Valley View Dr, Layton, UT 84040-7654 | 2015-07-07 |
1285033977 | Utah Family Care LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3575 S 3200 W Apt 6c, West Valley City, UT 84119-3571 | 2014-08-19 |
1982011649 | Teen Discovery Home | Residential Treatment Facility, Emotionally Disturbed Children | 10 East 100 South, Gunnison, UT 84634 | 2014-07-15 |
1245663947 | South Pointe Youth | Residential Treatment Facility, Emotionally Disturbed Children | 1500 South 580 West, Manti, UT 84642-0314 | 2013-08-16 |
1508207630 | Discovery Ranch for Girls | Residential Treatment Facility, Emotionally Disturbed Children | 4928 N 4500 W, Cedar City, UT 84721-5632 | 2013-07-17 |
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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.