Organization
LIFE TREE PLLC
Active
Other names
Life Tree Psychiatry, Life Tree
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSH HOOTON DNP, FNP-C, PMHNP-BC (OWNER/PROVIDER)
(805) 504-6665
Entity
Organization
Contact information
Practice address
251 W STATE ROAD 198 STE 3, SALEM, UT 84653-5608
(801) 504-6665
(801) 504-9073
Mailing address
251 W STATE ROAD 198 STE 3, SALEM, UT 84653-5608
(801) 504-6665
(801) 504-6073
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
6227164-4405
UT
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019033956
ANCC PMHNP BOARD CERTIFICATION
—
Enumeration date
03/27/2017
Last updated
10/21/2019
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