Queer Family Therapy, PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

QUEER FAMILY THERAPY, PLLC

Practice address

288 W Center St
Provo, UT 84601-4419

Phone

(509) 521-1536

NPI assigned

Jul 17, 2025

Last updated

Jul 17, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lacey Bagley, LMFTNPI 1174195697

Title

Owner

Phone

(509) 521-1536

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lacey Bagley, LMFT

  • Marriage & Family Therapist
  • Provo, UT
  • NPI 1174195697
  NPD Authorized official

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

{
    "created_epoch": "1752710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752710400000",
    "number": "1013809680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 UTAH AVE",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846065217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 W CENTER ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846014419",
            "telephone_number": "509-521-1536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEER FAMILY THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-17",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A",
        "authorized_official_last_name": "BAGLEY",
        "authorized_official_first_name": "LACEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-521-1536",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarinis Purcell
• Gina Lelala Mabel Purcell, LCSW
• Leslie Diane Putnam, APRN, FNP-C
• Christina Elizabeth Pyne
• Karlene Pyne
• Quell Counseling
• Shannon Quiner
• Mackenzie Irene Quinton
• Maycin Quiterio
• Jamie Quitoriano, RN

• Mental Health Clinic/Center (Including Community Mental Health Center) in Provo, UT
• Providers in Provo, UT by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.