| Uni Behavioral Health Clinics | |
|
650 Komas Dr 208 Slc UT 84108-1215 | |
| (801) 585-1212 | |
| (801) 585-9096 |
| Full Name | Uni Behavioral Health Clinics |
|---|---|
| Speciality | Clinic/Center |
| Location | 650 Komas Dr, Slc, Utah |
| Authorized Official Name and Position | Jeannine Rushton-fowler (CONTRACTING DIRECTOR) |
| Authorized Official Contact | 8015876336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Uni Behavioral Health Clinics Po Box 413076 Salt Lake City UT 84141-3076 Ph: (801) 585-1212 | Uni Behavioral Health Clinics 650 Komas Dr 208 Slc UT 84108-1215 Ph: (801) 585-1212 |
| NPI Number | 1720140114 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 05/28/2015 |
| Medicare PECOS PAC ID | 5294047114 |
|---|---|
| Medicare Enrollment ID | O20150707002039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720140114 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Douglas D Gray |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154429223 PECOS PAC ID: 2365497641 Enrollment ID: I20050319000030 |
| Provider Name | Matthew M Woolley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871691956 PECOS PAC ID: 8729016639 Enrollment ID: I20050802000295 |
| Provider Name | Matthew L Moench |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376641456 PECOS PAC ID: 5193725745 Enrollment ID: I20070104000089 |
| Provider Name | Richard S Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205800737 PECOS PAC ID: 9830297043 Enrollment ID: I20070612000736 |
| Provider Name | Rachele M Mccarthey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700933538 PECOS PAC ID: 0547309528 Enrollment ID: I20091204000099 |
| Provider Name | Rachel A Weir |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487779955 PECOS PAC ID: 5890822654 Enrollment ID: I20100427000621 |
| Provider Name | Julia Connelly |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396915609 PECOS PAC ID: 8426226838 Enrollment ID: I20110728000625 |
| Provider Name | Caralee C Cumming |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154633691 PECOS PAC ID: 1153591094 Enrollment ID: I20110831000631 |
| Provider Name | Anne G Lin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790883874 PECOS PAC ID: 9638141138 Enrollment ID: I20110913000009 |
| Provider Name | Mary E Steinmann |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386828606 PECOS PAC ID: 8729251921 Enrollment ID: I20111103000731 |
| Provider Name | L Kristin Shadow |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922028497 PECOS PAC ID: 0345408571 Enrollment ID: I20120220000836 |
| Provider Name | Bridget K Domeier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508111360 PECOS PAC ID: 0941444145 Enrollment ID: I20130909000738 |
| Provider Name | Patrick William Shea |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629203104 PECOS PAC ID: 8426280868 Enrollment ID: I20140612000745 |
| Provider Name | Amanda L Speer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740699792 PECOS PAC ID: 0840412003 Enrollment ID: I20141104001371 |
| Provider Name | Amy Wilson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427200898 PECOS PAC ID: 1052543808 Enrollment ID: I20141205002148 |
| Provider Name | Matthew Pierson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356584213 PECOS PAC ID: 8325362866 Enrollment ID: I20150112000263 |
| Provider Name | Elizabeth Botts |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124262886 PECOS PAC ID: 1850615568 Enrollment ID: I20150128000537 |
| Provider Name | Natalie Buerger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346637881 PECOS PAC ID: 8628382421 Enrollment ID: I20150807013876 |
| Provider Name | Steven Dale Lancaster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396028726 PECOS PAC ID: 1850698341 Enrollment ID: I20160329000393 |
| Provider Name | Sarah Wetmore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962754267 PECOS PAC ID: 3375833585 Enrollment ID: I20160531001872 |
| Provider Name | Michael Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619003449 PECOS PAC ID: 1850683632 Enrollment ID: I20160714002391 |
| Provider Name | Paul Stevens |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1366736886 PECOS PAC ID: 9234356627 Enrollment ID: I20160809001081 |
| Provider Name | Anna Docherty |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760844161 PECOS PAC ID: 4880973064 Enrollment ID: I20161110001002 |
| Provider Name | Heather Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700293446 PECOS PAC ID: 2062791874 Enrollment ID: I20161118001595 |
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