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SIDELINE SPORT PSYCHOLOGY PLLC
NPI 1053133322
Clinic/Center - Adult Mental Health in Salt Lake City, UT

Active since October 29, 2024
1336 S 1100 E, SALT LAKE CITY, UT 84105(385) 899-2251 Get Directions Write a Review

NPPES record last updated: October 29, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sideline Sport Psychology Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SIDELINE SPORT PSYCHOLOGY PLLC (NPI 1053133322) is a healthcare organization registered as an adult mental health in Salt Lake City, Utah and active in the NPI registry since October 2024. The organization lists Jourdan Johnson, Owner, as its authorized official.

NPPES Registry Identity

NPI1053133322
Entity TypeOrganization
Primary Taxonomy261QM0850X
Legal Business NameSIDELINE SPORT PSYCHOLOGY PLLC
Location Address1336 S 1100 ESalt Lake City, UT 84105-2421
Mailing Address4715 S Bron Breck StHolladay, UT 84117-6403 · (916) 690-6482
Phone(385) 899-2251
Organization SubpartNo
Authorized OfficialJourdan JohnsonOwner · (916) 690-0399
Enumeration DateOctober 29, 2024
NPPES CertifiedOctober 29, 2024
✔ NPI 1053133322 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0850X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
1336 S 1100 E, Salt Lake City, UT 84105
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Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTOPHER R. SWEENEY MD
Psychiatry & Neurology (Psychiatry)
1336 S 1100 E
SALT LAKE CITY, UT 84105
Salt Lake County (385) 246-2522
ZACKERY CHAD LARSEN CPSS
Peer Specialist
1336 S 1100 E
SALT LAKE CITY, UT 84105
Salt Lake County (385) 246-2522
BRITTANY ANN NORTHRUP LCSW
Social Worker (Clinical)
1336 S 1100 E
SALT LAKE CITY, UT 84105
Salt Lake County (801) 215-9661
AUBREY MEYER LCSW
Social Worker (Clinical)
1336 S 1100 E
SALT LAKE CITY, UT 84105
Salt Lake County (801) 450-7063
MOONLIT
Psychiatry & Neurology (Psychiatry)
1336 S 1100 E
SALT LAKE CITY, UT 84105
Salt Lake County (385) 246-2522
INTUITIVE ATHLETE
Dietitian, Registered
1336 S 1100 E
SALT LAKE CITY, UT 84105
Salt Lake County (801) 871-9252
CHEZLIE T JEDRZIEWSKI
Counselor (Mental Health)
1336 S 1100 E
SALT LAKE CITY, UT 84105
Salt Lake County (801) 251-6775

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sideline Sport Psychology PLLC's NPI number?

The NPI number for Sideline Sport Psychology PLLC is 1053133322. It was assigned to this organization in the NPPES registry on October 29, 2024.

Where is Sideline Sport Psychology PLLC located?

Sideline Sport Psychology PLLC is located at 1336 S 1100 E, Salt Lake City, UT 84105. The listed phone number is (385) 899-2251.

What is Sideline Sport Psychology PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

When was this NPI record last updated?

The NPPES record for Sideline Sport Psychology PLLC was last updated on October 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.