Individual provider Active NPI

Kristen Trinnaman, LCPC

  • Marriage & Family Therapist
  • Layton, UT
National Provider Identifier
1073290250
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
13409821-6009 Issued in UT
Practice address
476 Heritage Park Blvd Ste 230
Layton, UT 84041-5636
Phone
(801) 896-5345
Fax
(801) 896-5334
NPI assigned
Jun 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 13409821-6009 UT
Marriage & Family Therapist 106H00000X 13409821-6009 UT Primary

Addresses

Primary practice location

476 Heritage Park Blvd Ste 230
Layton, UT 84041-5636

Mailing address

PO Box 2516
Pocatello, ID 83206-2516
Phone (208) 252-5621

Other practice location 1

347 W Gordon Ave
Layton, UT 84041-2388
Phone (801) 896-5345

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
13409821-6009UTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Canvi Behavioral Health PLLC Professional CurrentSince Dec 10, 2023 Accepting new patients

Locations

4650 Hawthorne Rd
Ste 3B
Pocatello, ID 83202
Phone (208) 237-9833

476 Heritage Park Blvd
Ste 230
Layton, UT 84041
Phone (801) 896-5345

700 Foothill Blvd
Slc, UT 84113
Phone (801) 584-1900

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": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1073290250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2516",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832062516",
            "telephone_number": "208-252-5621",
            "fax_number": "208-648-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476 HERITAGE PARK BLVD STE 230",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415636",
            "telephone_number": "801-896-5345",
            "fax_number": "801-896-5334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "347 W Gordon Ave",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840412388",
            "country_code": "US",
            "telephone_number": "801-896-5345",
            "fax_number": "801-896-5334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRINNAMAN",
        "first_name": "KRISTEN",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "UT",
            "license": "13409821-6009",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "13409821-6009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.