OrganizationActive
Evidence Based Treatment Centers of Salt Lake City, PLLC
NPI 1326783689 · Clinical Psychologist · Holladay, UT
Provider details
- NPI number
- 1326783689
- Entity type
- Organization
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Parent organization
- Evidence Based Treatment Centers of Seattle, PLLC
- Organization subpart
- Yes
- Authorized official
- Adrienne Bennett, Clinic Coordinator(425) 361-9272
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Clinical Child & Adolescent Psychologist103TC2200X
Behavioral Health & Social Service Providers
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2225 E Murray Holladay Rd Ste 116
Holladay, UT 84117-5382
Phone: (206) 374-0109
Fax: (206) 374-0108
Street-level locationGet directions
Mailing address
1200 5th Ave Ste 800
Seattle, WA 98101-3136
Registry dates
- Enumerated
- 2022-05-02
- Last updated
- 2023-02-02
- Certified
- 2023-02-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.