Courtney Vandermyden

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2655 S Lake Erie Dr
West Valley, UT 84120-7350

Phone

(385) 441-4900

NPI assigned

Nov 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 23, 2024 through Apr 23, 2028

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Project Connection Utah

  • Mental Health Counselor
  • Salt Lake City, UT
  • NPI 1104392802
  NPD (past)
• Project Connection Utah LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Valley City, UT
  • NPI 1366330656
  NPD (past)

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1003573338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4866 W DIAMONDLEAF WAY",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840814759",
            "telephone_number": "916-712-1148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 S LAKE ERIE DR",
            "city": "WEST VALLEY",
            "state": "UT",
            "postal_code": "841207350",
            "telephone_number": "385-441-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERMYDEN",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexus Marie Touhuni I
• Lindsay Towler, DDS, MSD
• Popua Tukuafu
• University of Utah
• Mele Vainuku
• Kevin T Vick, CRNA
• Vision Experts Inc.
• Annie Kim Vu, MSWI
• Walgreen Co
• Adair Watts

• Mental Health Counselor in West Valley, UT
• Providers in West Valley, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.