Active NPI
Tyler McDonald
- Mental Health Counselor
- South Salt Lake, UT
National Provider Identifier
1144749755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 3610 S 1000 W
South Salt Lake, UT 84119-7829 - Phone
- (888) 949-4864
- NPI assigned
- Sep 14, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
3610 S 1000 W
South Salt Lake, UT 84119-7829
Mailing address
4460 S. Highland Dr.
Salt Lake City, UT 84124-3503
Other practice location 1
280 E 600 S
Salt Lake City, UT 84111-3564
Phone (888) 949-4864
Other practice location 2
3610 S 1000 W
South Salt Lake, UT 84119-7829
Phone (888) 949-4864
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539648000000",
"number": "1144749755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4460 S. HIGHLAND DR.",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841243503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3610 S 1000 W",
"city": "SOUTH SALT LAKE",
"state": "UT",
"postal_code": "841197829",
"telephone_number": "888-949-4864"
}
],
"practiceLocations": [
{
"address_1": "280 E 600 S",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841113564",
"country_code": "US",
"telephone_number": "888-949-4864",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3610 S 1000 W",
"address_purpose": "LOCATION",
"city": "South Salt Lake",
"state": "UT",
"postal_code": "841197829",
"country_code": "US",
"telephone_number": "888-949-4864",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCDONALD",
"first_name": "TYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-14",
"last_updated": "2018-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Salt Lake, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.