Thomas W Hazen, CMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

139747-6004 Issued in UT

Practice address

1300 E Center St
Provo, UT 84606-3554

Phone

(801) 344-4400

NPI assigned

Nov 10, 2006

Last updated

May 29, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• UT PPO D-SNP
• UT PPO

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1083785240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 E 100 N",
            "address_2": "SUITE 206",
            "city": "PAYSON",
            "state": "UT",
            "postal_code": "846511665",
            "telephone_number": "801-592-4040",
            "fax_number": "801-423-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E CENTER ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846063554",
            "telephone_number": "801-344-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZEN",
        "first_name": "THOMAS",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "CMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "139747-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Hayes
• Jared Haymore
• Brinlee Haynes
• Chalice Hazel
• Nicole Hazel
• Michael Austin Healey, D.O.
• Healing Within Counseling
• Healix LLC
• Health Clinics of Utah
• Healthcare Medical Supply Inc

• Mental Health Counselor in Provo, UT
• Providers in Provo, 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 May 29, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.