Individual provider Active NPI

Stephanie Carbajal, LMFT, RPT

  • Marriage & Family Therapist
  • Kaysville, UT
National Provider Identifier
1114186202
Registry record updated Sep 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
6726981-3902 Issued in UT
Practice address
375 N Main St Ste 102
Kaysville, UT 84037-1272
Phone
(801) 989-3488
Fax
(801) 989-5861
NPI assigned
Jun 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2021

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 6726981-3902 UT Primary

Addresses

Primary practice location

375 N Main St Ste 102
Kaysville, UT 84037-1272

Mailing address

375 N Main St Ste 102
Kaysville, UT 84037-1272
Phone (801) 989-3488

Other practice location 1

2317 N Hill Field Rd Ste 103
Layton, UT 84041-4782
Phone (801) 989-3488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Aug 16, 2024 through Aug 16, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6726981-3902UTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carbajal Counseling and Consulting, LLC Marriage & Family Therapist CurrentSince Sep 28, 2021 Accepting new patients
Carbajal Kids, LLC Current Accepting new patients
LDS Family Services Past Accepting new patients

Locations

375 N Main St
Ste 102
Kaysville, UT 84037
Phone (385) 324-6838

2317 N Hill Field Rd
Ste 103
Layton, UT 84041
Phone (801) 913-1212

Organizations & group practices 3

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": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631923200000",
    "number": "1114186202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 N MAIN ST STE 102",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840371272",
            "telephone_number": "801-989-3488",
            "fax_number": "801-989-5861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 N MAIN ST STE 102",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840371272",
            "telephone_number": "801-989-3488",
            "fax_number": "801-989-5861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2317 N Hill Field Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840414782",
            "country_code": "US",
            "telephone_number": "801-989-3488",
            "fax_number": "801-989-5861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARBAJAL",
        "first_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "credential": "LMFT, RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-04",
        "last_updated": "2021-09-18",
        "certification_date": "2021-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "6726981-3902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaysville, UT

Sources for this page

Verify at the official NPI Registry.