Active NPI
Shannon Smietana Boxley, LMFT
- Marriage & Family Therapist
- Park City, UT
National Provider Identifier
1467576561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 49066833902
- Practice address
- 1910 Prospector Ave
Suite 201
Park City, UT 84060-7211 - Phone
- (435) 645-9240
- Fax
- (435) 645-9237
- NPI assigned
- Mar 16, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 49066833902 | UT | Primary |
Addresses
Primary practice location
1910 Prospector Ave
Suite 201
Park City, UT 84060-7211
Mailing address
1910 Prospector Ave
Suite 201
Park City, UT 84060-7211
Phone (435) 645-9240
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 24, 2024 through Jan 24, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49066833902 | UT | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467576561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1910 PROSPECTOR AVE",
"address_2": "SUITE 201",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840607211",
"telephone_number": "435-645-9240",
"fax_number": "435-645-9237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1910 PROSPECTOR AVE",
"address_2": "SUITE 201",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840607211",
"telephone_number": "435-645-9240",
"fax_number": "435-645-9237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOXLEY",
"first_name": "SHANNON",
"middle_name": "SMIETANA",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "UT",
"license": "49066833902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.