Provider Demographics
NPI:1538638705
Name:ONE BY ONE BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:ONE BY ONE BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKIN
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:801-900-1353
Mailing Address - Street 1:1486 E 880 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-5413
Mailing Address - Country:US
Mailing Address - Phone:801-900-1353
Mailing Address - Fax:
Practice Address - Street 1:1454 E 820 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-5481
Practice Address - Country:US
Practice Address - Phone:801-900-1353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-17
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT3443536018OtherCERTIFIED ADVANCED SUBSTANCE USE DISORDER COUNSELOR
UT63259576004OtherCLINICAL MENTAL HEALTH COUNSELOR