Individual provider Active NPI

Shannon Marie Harris, LMFT

  • Marriage & Family Therapist
  • Sandy, UT
National Provider Identifier
1104577675
Registry record updated Jan 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
11109445-3902 Issued in UT
Practice address
11075 S State St Ste 35
Sandy, UT 84070-5187
Phone
(801) 809-7030
NPI assigned
Jan 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 11109445-3902 UT Primary

Addresses

Primary practice location

11075 S State St Ste 35
Sandy, UT 84070-5187

Mailing address

11075 S State St Ste 35
Sandy, UT 84070-5187
Phone (801) 809-7030

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
11109445-3902UTMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1642204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642204800000",
    "number": "1104577675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11075 S STATE ST STE 35",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840705187",
            "telephone_number": "801-809-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11075 S STATE ST STE 35",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840705187",
            "telephone_number": "801-809-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-15",
        "last_updated": "2022-01-15",
        "certification_date": "2022-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "11109445-3902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2022; 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.