Individual provider Active NPI

Stacie A. Sears, CSW

  • Mental Health Counselor
  • Salt Lake City, UT
National Provider Identifier
1114395324
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5473800-3502 Issued in UT
Practice address
1151 E 3900 S
Suite B299
Salt Lake City, UT 84124-1216
Phone
(801) 990-4300
NPI assigned
Sep 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 5473800-3502 UT Primary

Addresses

Primary practice location

1151 E 3900 S
Suite B299
Salt Lake City, UT 84124-1216

Mailing address

2880 W 4700 S
Suite G1
Taylorsville, UT 84129-2156
Phone (801) 990-4300

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
5473800-3502UTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Ridge Counseling LLC Past Accepting new patients

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": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1114395324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 W 4700 S",
            "address_2": "SUITE G1",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841292156",
            "telephone_number": "801-990-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 E 3900 S",
            "address_2": "SUITE B299",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241216",
            "telephone_number": "801-990-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEARS",
        "first_name": "STACIE",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "5473800-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.