Amy Deforest Edwards, ACMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

9045126-6009 Issued in UT

Practice address

Jewish Family Service
1111 E Brickyard Rd, Suite 218
SLC, UT 84106

Phone

(801) 746-4334

Fax

(801) 746-4337

NPI assigned

Jul 2, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 8, 2024 through Mar 8, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jewish Family Service

  • Community/Behavioral Health Agency
  • Salt Lake City, UT
  • NPI 1043446370
  NPD (past)

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1275949091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 E 1700 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JEWISH FAMILY SERVICE",
            "address_2": "1111 E BRICKYARD RD, SUITE 218",
            "city": "SLC",
            "state": "UT",
            "postal_code": "84106",
            "telephone_number": "801-746-4334",
            "fax_number": "801-746-4337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "AMY",
        "middle_name": "DEFOREST",
        "credential": "ACMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "9045126-6009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly R Earl
• Earth and Sky Acupuncture
• Eastgate Pediatric Dentistry
• Matthew Easthope
• Aileen Gayle Edwards, RN/BSN
• Kailee Edwards, DO
• Tiffany Edwards
• Tasha Nicole Ellchuk, BSC, MD, FRCPC
• Isabelle Empey
• ENT Professional Association Services

• Mental Health Counselor in SLC, UT
• Providers in SLC, 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 May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.