Provider Demographics
NPI:1346124294
Name:AUSTIN, CY JEDD
Entity type:Individual
Prefix:
First Name:CY
Middle Name:JEDD
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 S HIGHLAND DR APT 604
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-3579
Mailing Address - Country:US
Mailing Address - Phone:801-664-5681
Mailing Address - Fax:
Practice Address - Street 1:4190 S HIGHLAND DR STE 113
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-2673
Practice Address - Country:US
Practice Address - Phone:385-899-2251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health