Provider Demographics
NPI:1053555821
Name:JANET E. HOOPER, INC.
Entity type:Organization
Organization Name:JANET E. HOOPER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOOPER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-266-4643
Mailing Address - Street 1:6280 HATHAWAY ST
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84123-6695
Mailing Address - Country:US
Mailing Address - Phone:801-266-4643
Mailing Address - Fax:801-266-4775
Practice Address - Street 1:5689 S REDWOOD RD
Practice Address - Street 2:#28-2
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84123-5447
Practice Address - Country:US
Practice Address - Phone:801-266-4643
Practice Address - Fax:801-266-4775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT139616-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT548844168001Medicaid
UTR58082Medicare UPIN