NPIMap

Organization Active NPI

Kindled Light Therapy and Wellness

  • Mental Health Counselor
  • Provo, UT
National Provider Identifier
1295463578
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
KINDLED LIGHT THERAPY AND WELLNESS
Practice address
1881 N 1120 W
Provo, UT 84604-1180
Phone
(801) 228-8069
NPI assigned
Aug 12, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Authorized official

Name
Karen Pendleton, LCSWNPI 1720614258
Title
Owner
Phone
(801) 228-8069

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1881 N 1120 W
Provo, UT 84604-1180

Mailing address

455 W 390 S
Spanish Fork, UT 84660-4920
Phone (801) 228-8069

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1295463578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 W 390 S",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846604920",
            "telephone_number": "801-228-8069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 N 1120 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041180",
            "telephone_number": "801-228-8069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDLED LIGHT THERAPY AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-12",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "PENDLETON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-228-8069",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 May 17, 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.