Michelle M Wickersham, CMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

9012474-6004 Issued in UT

Practice address

476 Heritage Park Blvd Ste 220
Layton, UT 84041-5679

Phone

(801) 554-0006

Fax

(801) 899-7793

NPI assigned

Jan 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Micky M Wickersham Other name

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

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lampstand Counseling Services LLC

  • Mental Health Counselor
  • Layton, UT
  • NPI 1013899707
  Medicare reassignment NPD Authorized official
• Insight Solutions

  • Counselor
  • Layton, UT
  • NPI 1649988080
  NPD

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1275007338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1084 WEAVER LN",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840413514",
            "telephone_number": "801-554-0006",
            "fax_number": "801-899-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476 HERITAGE PARK BLVD STE 220",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415679",
            "telephone_number": "801-554-0006",
            "fax_number": "801-899-7793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4455 S 700 E Ste 300",
            "address_purpose": "LOCATION",
            "city": "Millcreek",
            "state": "UT",
            "postal_code": "841073076",
            "country_code": "US",
            "telephone_number": "801-899-9492",
            "fax_number": "801-899-7793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICKERSHAM",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "credential": "CMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-11",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "9012474-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICKY",
            "last_name": "WICKERSHAM",
            "middle_name": "M",
            "credential": "CMHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Trinity White
• Jessie Anna Jean Whitnack-Davidson
• Anna Lee Whitsel
• Karlianne Whittington
• Vincent Wiberg
• Wiconi Counseling Center
• Julie A. Wiese, M.D.
• Amy K Wight, RD, CD
• Bryan Kent Wilcox, M.D.
• Cathy Lynn Wilcox, SSW

• Mental Health Counselor in Layton, UT
• Providers in Layton, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.