| Herndon Psychotherapy And Evaluation Pllc | |
|
265 E 100 S Ste 275 Salt Lake City UT 84111-1649 | |
| (801) 350-3503 | |
| (801) 350-9582 |
| Full Name | Herndon Psychotherapy And Evaluation Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 265 E 100 S Ste 275, Salt Lake City, Utah |
| Authorized Official Name and Position | Amy Lambert (OFFICE MANAGER) |
| Authorized Official Contact | 8013503503 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Herndon Psychotherapy And Evaluation Pllc 265 E 100 S Ste 275 Salt Lake City UT 84111-1649 Ph: (801) 350-3503 | Herndon Psychotherapy And Evaluation Pllc 265 E 100 S Ste 275 Salt Lake City UT 84111-1649 Ph: (801) 350-3503 |
| NPI Number | 1881042612 |
|---|---|
| Provider Enumeration Date | 06/02/2016 |
| Last Update Date | 06/02/2016 |
| Medicare PECOS PAC ID | 5698069441 |
|---|---|
| Medicare Enrollment ID | O20160802002696 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881042612 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 7954817-2501 (Utah) | Primary |
| Provider Name | Natalie C Herndon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356537542 PECOS PAC ID: 6507150356 Enrollment ID: I20160802002776 |
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