Shanalyn Hunsaker, LMFT

Individual provider Active NPI Marriage & Family Therapist · Farr West, UT

NPI 1124679600 · NPPES record last updated Sep 30, 2024

Key facts

NPI
1124679600
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
11475086-3902 (UT)
Practice address
2850 N 2000 W Ste 101
Farr West, UT 84404-9230
Phone
(801) 528-5095
Fax
(801) 528-5094
NPI assigned
Sep 25, 2019
Sex
Female
Sole proprietor
Yes

Organizations & group practices 8

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.

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revere Health PC (407 clinicians)

Practice addresses (Care Compare)

2850 N 2000
Suite 101
Farr West, UT 84404-9230
Phone (801) 528-5095

Medicare participation

Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240318002512 UT Practitioner - Mental Health Counselor 6608213350 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles (4 of 6)

OrganizationSpecialtyStatusNew patients
Revere Health PC Current
since Oct 7, 2024
Accepting new patients
Revere Health PC Current
since Oct 7, 2024
Accepting new patients
Weber Human Services Current
since Feb 4, 2024
Accepting new patients
Weber Human Services Current
since Feb 4, 2024
Accepting new patients

Locations

2850 N 2000 W
Ste 201
Farr West, UT 84404
Phone (801) 354-0941

237 26th St
Ogden, UT 84401
Phone (801) 625-3605

2850 N 2000 W
Ste 101
Ogden, UT 84404
Phone (801) 528-5095

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

Networks

  • UT PPO
  • UT PPO D-SNP

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 11475086-3902 UT Yes

Addresses

Primary practice location

2850 N 2000 W Ste 101
Farr West, UT 84404-9230

Mailing address

1055 N 500 W
Att Credentialing
Provo, UT 84604
Phone (801) 354-8225

Other practice location 1

237 26th St
Ogden, UT 84401-3105
Phone (801) 352-3700

Other identifiers

IdentifierTypeStateIssuer
260022408OtherUTRAILRAOD MEDICARE
000055266OtherUTMEDICARE PIN
8760003008007MedicaidUT

Other names

  • Shanalyn Wheeler Former name

Other providers in Farr West, UT

All providers in Farr West, UT · Marriage & Family Therapist in Utah

Sources for this page

Verify at the official NPI Registry.