Individual provider Active NPI

Mandy Nielsen, CMHC

  • Mental Health Counselor
  • Salt Lake City, UT
National Provider Identifier
1134418379
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8027778-6004 Issued in UT
Practice address
5965 S 900 E
Salt Lake City, UT 84121-1720
Phone
(801) 263-7100
NPI assigned
Mar 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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 8027778-6004 UT Primary

Addresses

Primary practice location

5965 S 900 E
Salt Lake City, UT 84121-1720

Mailing address

5965 S 900 E
Salt Lake City, UT 84121-1720
Phone (801) 263-7100

Other names 1

  • Miss Mandy Jensen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240812002415 UT Practitioner - Mental Health Counselor 9739627555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7069 S Highland Dr
Suite 100
Salt Lake City, UT 84121-3731

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Paths Counseling LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

5882 S 900 E
Ste 303
Murray, UT 84121
Phone (385) 414-7704

7069 S Highland Dr
Ste 100
Salt Lake City, UT 84121
Phone (801) 214-1565

7069 S Highland Dr
Salt Lake City, UT 84121
Phone (801) 244-2021

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": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1134418379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5965 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211720",
            "telephone_number": "801-263-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5965 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211720",
            "telephone_number": "801-263-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "MANDY",
        "name_prefix": "Mrs.",
        "credential": "CMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-28",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "8027778-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDY",
            "last_name": "JENSEN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.