Tara Gunderson, CMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

12628515-6004 Issued in UT

Practice address

613 E Fort Union Blvd Ste 104
Midvale, UT 84047-5531

Phone

(801) 984-1717

NPI assigned

Dec 19, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Life Stone Group, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Midvale, UT
  • NPI 1871829283
  NPD (past)

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

{
    "created_epoch": "1734566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1295543585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 E FORT UNION BLVD STE 104",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840475531",
            "telephone_number": "801-984-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 E FORT UNION BLVD STE 104",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840475531",
            "telephone_number": "801-984-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSON",
        "first_name": "TARA",
        "credential": "CMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "12628515-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tony Scott Gregory, P.A.
• Jacob D Gremmert
• Chelsea Waldron Griffin, LCSW
• Garett Monty Groesbeck
• Regina Gulick, CMHC
• Isabel M Gutierrez, MT-BC
• Paige Nicole Gutzman, CMHC
• Christopher Hae, BSW, ASUDC STUDENT
• Patricia Dawn Hagler, CFM
• Savannah Hakes

• Mental Health Counselor in Midvale, UT
• Providers in Midvale, 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 Dec 19, 2024; 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.