Individual provider Active NPI

Mikenna Giauque, MC

  • Mental Health Counselor
  • Centerville, UT
National Provider Identifier
1215620802
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
520 N Market Place Dr Ste 200
Centerville, UT 84014-4904
Phone
(801) 934-3373
NPI assigned
May 30, 2023
Last updated
Oct 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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 NU Primary

Addresses

Primary practice location

520 N Market Place Dr Ste 200
Centerville, UT 84014-4904

Mailing address

1606 Vineyard Dr # B
Bountiful, UT 84010-1398
Phone (480) 662-7757

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
I20260213002264 UT Practitioner - Mental Health Counselor 4082194550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

520 N Market Place Dr
Suite 200
Centerville, UT 84014-4904

PO Box
Suite 167
Kaysville, UT 84037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Davis Psychological Services CurrentSince Jan 1, 2026 Accepting new patients
Neurorev PLLC CurrentSince Oct 21, 2025 Accepting new patients

Locations

185 S 400 E
Ste 100
Bountiful, UT 84010
Phone (801) 292-5070

520 N Market Place Dr
Ste 200
Centerville, UT 84014
Phone (801) 243-6822

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1215620802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 VINEYARD DR # B",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840101398",
            "telephone_number": "480-662-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N MARKET PLACE DR STE 200",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840144904",
            "telephone_number": "801-934-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIAUQUE",
        "first_name": "MIKENNA",
        "credential": "MC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, UT

Sources for this page

Verify at the official NPI Registry.