NPIMap

Organization Active NPI

Palisades Counseling LLC

  • Counseling Psychologist
  • Provo, UT
National Provider Identifier
1225817414
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
PALISADES COUNSELING LLC
Practice address
3319 N University Ave Ste 100
Provo, UT 84604-4447
Phone
(801) 356-0014
NPI assigned
Sep 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shawn Edgington, PHDNPI 1457498271
Title
Owner
Phone
(801) 356-0014

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

3319 N University Ave Ste 100
Provo, UT 84604-4447

Mailing address

3319 N University Ave Ste 100
Provo, UT 84604-4447
Phone (801) 356-0014

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1225817414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3319 N UNIVERSITY AVE STE 100",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846044447",
            "telephone_number": "801-356-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 N UNIVERSITY AVE STE 100",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846044447",
            "telephone_number": "801-356-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALISADES COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "EDGINGTON",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-356-0014",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.