Individual provider Active NPI

Justin K Stum, LMFT

  • Marriage & Family Therapist
  • Saint George, UT
National Provider Identifier
1457590671
Registry record updated Jun 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
5617226-3902 Issued in UT
Practice address
640 E 700 S
Suite 103
Saint George, UT 84770-4023
Phone
(435) 574-9193
NPI assigned
Feb 11, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 5617226-3902 UT Primary

Addresses

Primary practice location

640 E 700 S
Suite 103
Saint George, UT 84770-4023

Mailing address

640 E 700 S
Suite 103
Saint George, UT 84770-4023
Phone (435) 574-9193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240513000885 UT Practitioner - Marriage and Family Therapist 7113368887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

163 W 1600
Suite 3
Saint George, UT 84770-6715
Phone (435) 216-8839

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5617226-3902UTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elevated Counseling and Wellness LLC CurrentSince Apr 15, 2024 Accepting new patients

Locations

169 N Gateway Dr
Ste 233
Providence, UT 84332
Phone (435) 301-6865

163 W 1600 S
Ste 3
St George, UT 84770
Phone (435) 216-8839

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": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370563200000",
    "number": "1457590671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 E 700 S",
            "address_2": "SUITE 103",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847704023",
            "telephone_number": "435-574-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E 700 S",
            "address_2": "SUITE 103",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847704023",
            "telephone_number": "435-574-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUM",
        "first_name": "JUSTIN",
        "middle_name": "K",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-11",
        "last_updated": "2013-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "5617226-3902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint George, UT

Sources for this page

Verify at the official NPI Registry.