Individual provider Active NPI

Mark A Dennison, LCPC, LPC

  • Mental Health Counselor
  • North Ogden, UT
National Provider Identifier
1053562041
Registry record updated Oct 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC 4790346-6004 Issued in UT
Practice address
3146 N 450 E
North Ogden, UT 84414-1612
Phone
(801) 388-1650
Fax
(801) 216-4212
NPI assigned
Oct 8, 2008
Last updated
Oct 8, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC 4790346-6004 UT Primary
Mental Health Counselor 101YM0800X LPCC 0906 KY
Mental Health Counselor 101YM0800X LPC 978 WY

Addresses

Primary practice location

3146 N 450 E
North Ogden, UT 84414-1612

Mailing address

3146 N 450 E
North Ogden, UT 84414-1612
Phone (801) 388-1650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPCC 0906KYMDMental Health Counselor
LPC 4790346-6004UTMDMental Health Counselor
LPC 978WYMDMental 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": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1053562041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3146 N 450 E",
            "city": "NORTH OGDEN",
            "state": "UT",
            "postal_code": "844141612",
            "telephone_number": "801-388-1650",
            "fax_number": "801-216-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3146 N 450 E",
            "city": "NORTH OGDEN",
            "state": "UT",
            "postal_code": "844141612",
            "telephone_number": "801-388-1650",
            "fax_number": "801-216-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNISON",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "LCPC, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-08",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "LPC 4790346-6004",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "LPCC 0906",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WY",
            "license": "LPC 978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.