Korinne K. Bouwhuis, LMFT, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

5165227-3902 Issued in UT

Practice address

175 W. 1400 N.
Ste a. LDS Family Services
Logan, UT 84341

Phone

(435) 752-5302

Fax

(435) 753-9007

NPI assigned

Nov 17, 2006

Sex

Female

Sole proprietor

No

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

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• LDS Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Logan, UT
  • NPI 1801994132
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1124191945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 W 1400 N.",
            "address_2": "STE A. LDS FAMILY SERVICES",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "84341",
            "telephone_number": "435-752-5302",
            "fax_number": "435-753-9007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 W. 1400 N.",
            "address_2": "STE A. LDS FAMILY SERVICES",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "84341",
            "telephone_number": "435-752-5302",
            "fax_number": "435-753-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUWHUIS, LMFT",
        "first_name": "KORINNE",
        "middle_name": "K.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "5165227-3902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Booton, M.S.N, F.N.P,
• Philip Michael Boozer, ATC, CPT, CES
• Matthew Michael Borkovich, MD
• Daniel Agee Boston, DDS
• Samuel Boucher
• Austin Joe Bowles, M.D.
• Shane Boyce, PT
• Anna Boyes
• Kay Bradford, PHD
• Kayce C Bradley

• All providers in Logan, UT
• Marriage & Family Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.