# PINEBROOK MENTAL HEALTH THERAPY INC.

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

## Provider details

- **NPI number:** 1659192425
- **Authorized official:** DR. JACQUELINE HYDE PSYD, CMHC (CEO)
- **Authorized official phone:** (435) 562-1903

## Contact information

- **Practice address:** 3100 PINEBROOK RD STE 1250B, PARK CITY, UT 84098-5663
- **Practice address phone:** (435) 562-1903
- **Mailing address:** 3100 PINEBROOK RD STE 1250B, PARK CITY, UT 84098-5663
- **Mailing address phone:** (435) 562-1903

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 10/23/2024
- **Last updated:** 12/22/2024