Evidence Based Treatment Centers of Salt Lake City, PLLC
NPI 1326783689ActiveOrganization· Psychologist, Clinical· Holladay, UT
Psychologist, Clinical in Holladay, Utah, registered in NPPES in May 2022, part of Evidence Based Treatment Centers of Seattle, PLLC. The authorized official on file is Adrienne C. Bennett, BS, Clinic Coordinator.
Overview
| NPI | 1326783689 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Evidence Based Treatment Centers of Seattle, PLLC |
| NPI issued | May 2, 2022 |
| Last updated in NPPES | Feb 2, 2023 |
| Certified by provider | Feb 2, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | — | — |
| Psychologist, Clinical Child & Adolescent | 103TC2200X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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