Taylor L Petersen, LMFT
Individual provider Active NPI Marriage & Family Therapist · Delta, UT
NPI 1487507174 · NPPES record last updated Mar 23, 2026
Key facts
- NPI
- 1487507174
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 13791122-3902 (UT)
- Practice address
- 130 White Sage Ave
Delta, UT 84624-8928 - Phone
- (435) 864-2708
- NPI assigned
- Feb 20, 2026
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ihc Health Services Inc
Practice addresses (Care Compare)
130 White Sage Ave
Delta, UT 84624-8928
Phone (435) 864-2708
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260420002034 | UT | Practitioner - Marriage and Family Therapist | 2769958404 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13791122-3902 | UT | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 13791122-3902 | UT | Yes |
Addresses
Primary practice location
130 White Sage Ave
Delta, UT 84624-8928
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other practice location 1
700 Ut-99
Fillmore, UT 84631
Phone (435) 743-5555
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Bluemark LLC/ Office Ally |
Other providers in Delta, UT
- Cody Nielson
- Drew Nielson
- Spencer Gordon Nielson
- Glenys E Parkinson
- Peak Performance Chiropractic and Sports Rehabilitation Center LLC
- Ryan Peterson
- Marlow Plumb
- Skyler Porter
- Katie Poulsen
- Louis Howard Quackenbush II
All providers in Delta, UT · Marriage & Family Therapist in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.