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Organization
FUNCTIONALLY INTEGRATIVE THERAPY LLC
Active
Organization
FUNCTIONALLY INTEGRATIVE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN ROTH LCSW (OWNER/THERAPIST)
(385) 208-6197
Entity
Organization
Contact information
Practice address
5620 S WATERBURY WAY, SALT LAKE CITY, UT 84121-1180
(385) 208-6197
Mailing address
PO BOX 18182, KEARNS, UT 84118-0182
(385) 208-6197
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
Other
Enumeration date
08/29/2025
Last updated
08/29/2025
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