Provider Demographics
NPI:1568838183
Name:BENJAMIN CHRISTIANSEN, LLC
Entity Type:Organization
Organization Name:BENJAMIN CHRISTIANSEN, LLC
Other - Org Name:UTAH CENTER FOR ASSESMENT & TREATMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTIANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:801-784-7605
Mailing Address - Street 1:890 HERITAGE PARK BLVD
Mailing Address - Street 2:STE 104
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-5656
Mailing Address - Country:US
Mailing Address - Phone:801-784-7605
Mailing Address - Fax:801-896-0175
Practice Address - Street 1:890 HERITAGE PARK BLVD
Practice Address - Street 2:STE 104
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-5656
Practice Address - Country:US
Practice Address - Phone:801-784-7605
Practice Address - Fax:801-896-0175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty