Organization · Type 2 NPI

University of Utah Pediatric Behavioral Health Services

Child & Adolescent Psychiatry Physician · Salt Lake City, UT

NPI number 1174073746 Active

Practice location

501 S Chipeta Way
Salt Lake City, UT 84108-1222

Call (801) 585-1575 Map

Mailing address

PO Box 413021
Salt Lake City, UT 84141-3021

Specialties and licenses

Taxonomy	Code	License
Child & Adolescent Psychiatry Physician Primary	2084P0804X	None listed

Child & Adolescent Psychiatry Physician: Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

210 other providers at this address

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NPI record

NPI: 1174073746
Entity type: Organization (Type 2)
Issued: Oct 7, 2016
Last updated: Oct 7, 2016
Status: Active
Subpart: Yes of University of Utah Pediatric Behavioral Health Services

Other names

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Pediatric Behavioral Health Outpatient SVCS · doing business as

Authorized official

Edward Clark, MD
Department Chair
(801) 587-6336

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1174073746

University of Utah Pediatric Behavioral Health Services's National Provider Identifier is 1174073746, issued on Oct 7, 2016. The primary taxonomy on file is Child & Adolescent Psychiatry Physician (2084P0804X), and the practice location is in Salt Lake City, UT. The record was last updated on Oct 7, 2016.