Provider Demographics
NPI:1902628373
Name:PEACE AND EQUALITY THERAPY PC
Entity type:Organization
Organization Name:PEACE AND EQUALITY THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIBYL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:307-389-1041
Mailing Address - Street 1:216 N 900 W
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84116
Mailing Address - Country:US
Mailing Address - Phone:307-389-1041
Mailing Address - Fax:
Practice Address - Street 1:231 E 400 S
Practice Address - Street 2:STE 370
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111
Practice Address - Country:US
Practice Address - Phone:801-252-6727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty