Brandie Statham

Individual provider Active NPI Mental Health Counselor · American Fork, UT

NPI 1225961972 · NPPES record last updated Jun 3, 2026

Key facts

NPI
1225961972
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
384 E 60 S
American Fork, UT 84003-3835
Phone
(801) 901-0279
NPI assigned
Jun 3, 2026
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Olympus Ink Systems Mental Health Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

384 E 60 S
American Fork, UT 84003-3835

Mailing address

384 E 60 S
American Fork, UT 84003-3835
Phone (801) 901-0279

Other providers in American Fork, UT

All providers in American Fork, UT · Mental Health Counselor in Utah

Sources for this page

Verify at the official NPI Registry.