Individual provider Active NPI

Denise Marie Boelens, PH.D.

  • Clinical Psychologist
  • Murray, UT
National Provider Identifier
1023077062
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
110944-2501 Issued in UT
Practice address
5801 Fashion Blvd
Suite 250
Murray, UT 84107-6159
Phone
(801) 596-0147
NPI assigned
Mar 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 110944-2501 UT Primary

Addresses

Primary practice location

5801 Fashion Blvd
Suite 250
Murray, UT 84107-6159

Mailing address

5801 Fashion Blvd
Suite 250
Murray, UT 84107-6159
Phone (801) 596-0147

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
I20080424000304 UT Practitioner - Clinical Psychologist 4688752199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1980
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5801 S Fashion Blvd
Suite 250
Murray, UT 84107-6145
Phone (801) 913-5543

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
110944-2501UTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Whitehawk Consulting, P.C. Clinical CurrentSince Mar 22, 2002 Accepting new patients

Locations

5801 S Fashion Blvd
Ste 250
Salt Lake City, UT 84107
Phone (801) 596-0147

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295395200000",
    "number": "1023077062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 FASHION BLVD",
            "address_2": "SUITE 250",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076159",
            "telephone_number": "801-596-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 FASHION BLVD",
            "address_2": "SUITE 250",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076159",
            "telephone_number": "801-596-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOELENS",
        "first_name": "DENISE",
        "middle_name": "MARIE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2011-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "110944-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.