# MOUNTAIN LAND FAMILY THERAPY CLINICS LC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558478677
- **Authorized official:** MR. MARK ANDERSON PT (PRESIDENT)
- **Authorized official phone:** (801) 942-3311

## Contact information

- **Practice address:** 3570 W 9000 S, SUITE 120, W JORDAN, UT 84088-8874
- **Practice address phone:** (801) 561-8888
- **Mailing address:** PO BOX 711185, SALT LAKE CITY, UT 84171
- **Mailing address phone:** (801) 942-3311
- **Mailing address fax:** (801) 942-5955

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |

## Other

- **Enumeration date:** 08/24/2006
- **Last updated:** 09/11/2025