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

Sideline Sport Psychology PLLC

Organization Adult Mental Health Clinic/Center · NPI 1053133322

Sideline Sport Psychology PLLC is an Adult Mental Health Clinic/Center in Salt Lake City, Utah. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1336 S 1100 E
Salt Lake City, UT 84105-2421
Phone: (385) 899-2251
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Mental Health Clinic/Center (primary) Taxonomy 261QM0850X

Record details

NPI number1053133322
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jourdan Johnson — Owner · (916) 690-0399
NPI enumeratedOctober 29, 2024
Last updated in NPPESOctober 29, 2024
Certification dateOctober 29, 2024
Mailing address4715 S Bron Breck St, Holladay, UT 84117-6403

Other providers in Salt Lake City