Great Salt Lake Wellness Inc
NPI 1790152940 · Clinical Psychologist · Kaysville, UT
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Great Salt Lake Wellness Inc is a Clinical Psychologist organization in Kaysville, UT (NPI 1790152940).
Provider details
- NPI number
- 1790152940
- Entity type
- Organization
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Emily Bullock, Owner(801) 389-9521
- License
- 7510289-2501 (UT)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 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
Mailing address
Registry dates
- Enumerated
- 2015-08-24
- Last updated
- 2024-04-17
- Certified
- 2024-04-17
Frequently asked questions
- What is Great Salt Lake Wellness Inc's NPI number?
- Great Salt Lake Wellness Inc's National Provider Identifier (NPI) is 1790152940, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Great Salt Lake Wellness Inc?
- Great Salt Lake Wellness Inc is classified in the NPPES registry as Clinical Psychologist (Behavioral Health & Social Service Providers).
- Where is Great Salt Lake Wellness Inc located?
- Great Salt Lake Wellness Inc's practice location on file with NPPES is 375 N Main St Ste 202, Kaysville, UT 84037-1278.
- What is Great Salt Lake Wellness Inc's phone number?
- The practice phone number listed in the NPPES registry for Great Salt Lake Wellness Inc is (801) 844-1615.
- Does Great Salt Lake Wellness Inc accept Medicare?
- Great Salt Lake Wellness Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Great Salt Lake Wellness Inc?
- The authorized official listed on Great Salt Lake Wellness Inc's NPPES record is Emily Bullock, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Great Salt Lake Wellness Inc's NPI active?
- Yes — Great Salt Lake Wellness Inc's NPI (1790152940) is active in the NPPES registry as of the last update on 2024-04-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.