Brent Keeler Shuster, ACMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

11226387-6004 Issued in UT

Practice address

3556 S 5600 W # 1-472
Salt Lake City, UT 84120-2815

Phone

(801) 210-9443

NPI assigned

Feb 6, 2018

Last updated

Mar 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 4, 2024 through Jan 4, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1417456401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 5600 S STE 304",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841078174",
            "telephone_number": "801-210-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3556 S 5600 W # 1-472",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841202815",
            "telephone_number": "801-210-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUSTER",
        "first_name": "BRENT",
        "middle_name": "KEELER",
        "credential": "ACMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-06",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "11226387-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luisa Mercedes Shumway
• Maureen Elizabeth Shumway, RN
• Saydria Eyre Shumway, CSW
• Stephen M Shupe, M.S., P.T., O.C.S.
• Deborah Kristine Shurtleff
• Virginia Shutt, CPCI
• Kiera N. Sibbald, MD
• Karli Alyn Sibley, PA-C
• Rosa Sibrian
• Anna M Siciliano, M.A, C.C.C., S.L.P.

• 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 Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.