Organization Active NPI

Ascent Family Therapy, Inc

  • Professional Counselor
  • Provo, UT
National Provider Identifier
1386288462
Registry record updated Oct 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
ASCENT FAMILY THERAPY, INC
Practice address
4665 Mile High Dr
Provo, UT 84604-6311
Phone
(408) 431-4443
NPI assigned
Nov 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2020

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

Authorized official

Name
Mr. Daniel Burgess, LMFTNPI 1285189514
Title
Ceo
Phone
(408) 431-4443

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Pastoral CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP1600X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
School CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YS0200X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

4665 Mile High Dr
Provo, UT 84604-6311

Mailing address

PO Box 902
Provo, UT 84603-0902
Phone (408) 431-4443

National Provider Directory

National Provider Directory

Locations

3375 Scott Blvd
Ste 422
Santa Clara, CA 95054

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": "1572566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602288000000",
    "number": "1386288462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 902",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846030902",
            "telephone_number": "408-431-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4665 MILE HIGH DR",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046311",
            "telephone_number": "408-431-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENT FAMILY THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-01",
        "last_updated": "2020-10-10",
        "certification_date": "2020-10-10",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-431-4443",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Oct 10, 2020; 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.