Organization
INTEGRATED PSYCHOTHERAPY SERVICES
Active
Other names
IPSSE
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH R. GOUVEIA-GRANT CMHC (CLINICIAN)
(801) 520-7938
Entity
Organization
Contact information
Practice address
352 S DENVER ST STE 315, SALT LAKE CITY, UT 84111-3054
(801) 520-7938
(800) 528-1208
Mailing address
PO BOX 508, SALT LAKE CITY, UT 84110-0508
(801) 520-7938
(800) 528-1208
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790125730
—
UT
Enumeration date
08/07/2019
Last updated
07/20/2021
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