OrganizationActive
Soul Growth LLC
NPI 1417469115 · Mental Health Clinic/Center (Including Community Mental Health Center) · Salt Lake City, UT
Provider details
- NPI number
- 1417469115
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jessica Vasa, Mental Health Clinician(307) 389-8044
- License
- 10492016-3501 (UT)
Specialties & taxonomies
- Mental Health Clinic/Center (Including Community Mental Health Center)Primary261QM0801XLicense 10492016-3501 (UT)
Ambulatory Health Care Facilities
Profile Score
Established profile(69/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 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
1719 S Main St
Salt Lake City, UT 84115-1911
Phone: (307) 389-8044
Street-level locationGet directions
Mailing address
2011 S 2100 E Apt 306
Salt Lake City, UT 84108-3176
Registry dates
- Enumerated
- 2017-11-02
- Last updated
- 2017-11-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.