Active NPI
Maren Maurine Ernstrom, CMHC
- Mental Health Counselor
- Draper, UT
National Provider Identifier
1396258695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 8152182-6004
- Practice address
- 1481 E Pioneer Rd
Draper, UT 84020-9623 - Phone
- (801) 661-4875
- NPI assigned
- Nov 8, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 8152182-6004 | UT | Primary |
Addresses
Primary practice location
1481 E Pioneer Rd
Draper, UT 84020-9623
Mailing address
1481 E Pioneer Rd
Draper, UT 84020-9623
Phone (801) 661-4875
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8152182-6004 | UT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deer Hollow Recovery LLC | Past | Accepting new patients | |
| Care One Partners LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Draper, UT
- NPI 1932618873
-
- Psychiatric Residential Treatment Facility
- Draper, UT
- NPI 1821473224
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510099200000",
"number": "1396258695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1481 E PIONEER RD",
"city": "DRAPER",
"state": "UT",
"postal_code": "840209623",
"telephone_number": "801-661-4875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1481 E PIONEER RD",
"city": "DRAPER",
"state": "UT",
"postal_code": "840209623",
"telephone_number": "801-661-4875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERNSTROM",
"first_name": "MAREN",
"middle_name": "MAURINE",
"credential": "CMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-08",
"last_updated": "2017-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "UT",
"license": "8152182-6004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.