Individual provider Active NPI

Alex Blankenstein, ACMHC

  • Mental Health Counselor
  • Salt Lake City, UT
National Provider Identifier
1003312109
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10382410-6009 Issued in UT
Practice address
151 E 5600 S Ste 300
Salt Lake City, UT 84107-8149
Phone
(801) 462-2150
NPI assigned
Apr 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10382410-6009 UT Primary

Addresses

Primary practice location

151 E 5600 S Ste 300
Salt Lake City, UT 84107-8149

Mailing address

151 E 5600 S Ste 300
Salt Lake City, UT 84107-8149
Phone (801) 462-2150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260320003271 UT Practitioner - Mental Health Counselor 5193209765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10323 S Clarks Hill Dr
South Jordan, UT 84009-1210

170 S Interstate PLZ
Suite 100
Lehi, UT 84043-8601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10382410-6009UTMDMental Health Counselor

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1003312109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 E 5600 S STE 300",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841078149",
            "telephone_number": "801-462-2150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 E 5600 S STE 300",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841078149",
            "telephone_number": "801-462-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENSTEIN",
        "first_name": "ALEX",
        "credential": "ACMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-05",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "10382410-6009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.