Rivendell Clinic LLC

NPI #1326745787 in Provo, Utah

Provider Information

NPI Number: 1326745787
Entity Type: Organization
Organization Name: Rivendell Clinic LLC
Primary Specialty: Clinic/Center
Enumeration Date: Feb 15, 2023
Last Updated: Dec 3, 2025

Practice Location

Address: 3507 N UNIVERSITY AVE STE 350F
City: Provo
State: Utah
ZIP Code: 84604-4478
Phone: (385) 446-5010

Authorized Official

Name: DR. SARAH INGERSON, DNP
Title: DR
Phone: (385) 985-8423

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X
Clinic/Center	261Q00000X	Primary

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