Alexis Izatt

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

14240290-6009 Issued in UT

Practice address

111 E 5600 S Ste 200
Salt Lake City, UT 84107-8158

Phone

(385) 346-0031

NPI assigned

Mar 10, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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.

• Radiant Moon, PLLC

  • Mental Health Counselor
  • Midvale, UT
  • NPI 1811651938
  NPD (past)

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1396544763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16255 VENTURA BLVD STE 830",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 5600 S STE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841078158",
            "telephone_number": "385-346-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZATT",
        "first_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "14240290-6009",
            "primary": true
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": null,
            "license": "25-542",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Lawrence Iwasaki, PA-C
• Lucky Iye
• Rajiv Iyer, MD
• Varsha Iyer, MD
• Lucy Izard
• McCall Izatt
• Diego Ize-Ludlow, MD
• Izzy Inc.
• J Barry Robb MD Professional Corporation
• J C Enterprises Inc

• Mental Health Counselor in Salt Lake City, UT
• Providers in Salt Lake City, 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 Oct 13, 2025; 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.