Mary Christena Attridge, CMHC, ATR-BC, ATCS
Individual provider Active NPI Professional Counselor · Midvale, UT
NPI 1295025575 · NPPES record last updated Jun 11, 2019
Key facts
- NPI
- 1295025575
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 9022525-6004 (UT)
- Practice address
- 6770 S 900 E Ste 105
Midvale, UT 84047-1710 - Phone
- (801) 305-3171
- Fax
- (801) 904-3632
- NPI assigned
- Apr 8, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
- Opted out of Medicare
- Yes, effective Jun 1, 2024 through Jun 1, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9022525-6004 | UT | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Healing Group, PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Art Therapist | 221700000X | 06-009 | ||
| Professional Counselor |
101YP2500X | 9022525-6004 | UT | Yes |
Addresses
Primary practice location
6770 S 900 E Ste 105
Midvale, UT 84047-1710
Mailing address
6770 S 900 E Ste 105
Midvale, UT 84047-1710
Phone (801) 305-3171
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06-009 | Other | ATR-BC, ATCS | |
| 9022525-6004 | Other | UT | CMHC LICENSE |
Other providers in Midvale, UT
- Alyssa Brooke Arko
- Manuel Alejandro Armenta
- Amie Jo Aslami
- Robin Asmar
- Sabrina Lyn Atkinson
- Isabella Reese Augustine
- Natalie J Avery
- Erin Aycox
- Emmanuel Azike II
- Alexandrea Babcock
All providers in Midvale, UT · Professional Counselor in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.