Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Functionally Integrative Therapy LLC

Organization Clinical Social Worker · NPI 1184503492

Functionally Integrative Therapy LLC is a Clinical Social Worker in Salt Lake City, Utah. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5620 S Waterbury Way
Salt Lake City, UT 84121-1180
Phone: (385) 208-6197
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X
Adult Mental Health Clinic/Center Taxonomy 261QM0850X

Record details

NPI number1184503492
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Steven Roth — Owner/Therapist · (385) 208-6197
NPI enumeratedAugust 29, 2025
Last updated in NPPESAugust 29, 2025
Certification dateAugust 29, 2025
Mailing addressPo Box 18182, Kearns, UT 84118-0182

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