Individual provider Active NPI

Kaitlin Thomas, CMHC

  • Mental Health Counselor
  • American Fork, UT
National Provider Identifier
1427696103
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10397680-6004 Issued in UT
Practice address
150 E 400 S
American Fork, UT 84003-2445
Phone
(801) 980-7222
Fax
(801) 980-7223
NPI assigned
Dec 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10397680-6004 UT Primary

Addresses

Primary practice location

150 E 400 S
American Fork, UT 84003-2445

Mailing address

613 E Fort Union Blvd Ste 104
Midvale, UT 84047-5531
Phone (801) 984-1717

Other practice location 1

613 E Fort Union Blvd Ste 104
Midvale, UT 84047-5531
Phone (801) 984-1717

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

LicenseStateTypeSpecialty
10397680-6004UTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Life Stone Group, LLC PastSince Dec 15, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1427696103",
    "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",
            "fax_number": "801-984-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E 400 S",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032445",
            "telephone_number": "801-980-7222",
            "fax_number": "801-980-7223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "613 E Fort Union Blvd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Midvale",
            "state": "UT",
            "postal_code": "840475531",
            "country_code": "US",
            "telephone_number": "801-984-1717",
            "fax_number": "801-984-1720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KAITLIN",
        "credential": "CMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "10397680-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.