CRYSTAL TINA MARIE AMEZQUITA (NPI# 1891274429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1891274429 |
Entity Type | Individual |
Full Name | CRYSTAL TINA MARIE AMEZQUITA |
Practice Address |
1141 E 3900 S Ste A150 Salt Lake City UT 84124-1215 |
Mailing Address |
4460 S Highland Dr Salt Lake City UT 84124-3543 |
Practice Telephone | 8889494864 |
Enumeration Date | 2018-08-14 |
Last Update Date | 2018-08-14 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 251S00000X | Community/Behavioral Health | Agencies |
Street Address |
1141 E 3900 S STE A150 |
City | SALT LAKE CITY |
State | UT |
Zip Code | 84124-1215 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487273298 | Shannon Penny Price | Social Worker | 4465 Maybeck Place, Condo C, Millcreek, UT 84124 | 2020-04-11 |
1922654367 | Joseph C Melvin Md PC | Colon & Rectal Surgery | 1250 East 3900 South Ste 320, Salt Lake City, UT 84124 | 2019-08-12 |
1366923252 | Melanie Stumpf | Counselor | 1141 E 3900, Suite A170, Salt Lake City, UT 84124 | 2018-08-28 |
1376033993 | Michelle Flowers | Speech-Language Pathologist | 2120 East 3900 South, Ste 200, Holladay, UT 84124 | 2018-05-18 |
1740797257 | Lissa Anne Hutchings | Nurse Practitioner | 1160 E 3900 S Ste 4100, Salt Lake City, UT 84124 | 2018-01-05 |
1316465693 | Randy Gines | Counselor | 4460 S Highland Drive # 230, Murray, UT 84124 | 2017-09-06 |
1417470717 | Joshua Chandler Spencer | Counselor | 4460 South Highland Dr., 230, Murray, UT 84124 | 2017-07-19 |
1659891554 | Marcus Whitney | Counselor | 4460 S Highland Dr. # 230, Murray, UT 84124 | 2017-06-21 |
1518496884 | Courtney Nilson | Counselor | 4460 S. Highland Dr. #230, Murray, UT 84124 | 2017-06-08 |
1841687126 | Intrafilrx | Preferred Provider Organization | 3920 S 1100 E Ste 210, Salt Lake City, UT 84124 | 2015-04-23 |
Find all providers in zip 84124 |
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 |
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 |
1396280509 | Rjr Consultants LLC | Community/Behavioral Health | 169 E Edith Ave, Salt Lake City, UT 84111-4502 | 2016-12-23 |
Find all providers in SALT LAKE CITY |
City | SALT LAKE CITY |
Zip Code | 84124 |
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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.