Active NPI
Kenneth Eugene Thevenin, LMFT
- Marriage & Family Therapist
- Salt Lake City, UT
National Provider Identifier
1497767313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 282730-3902
- Practice address
- 50 E North Temple FL 8
Salt Lake City, UT 84150-4412 - Phone
- (806) 401-4661
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- 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 | 282730-3902 | UT | Primary |
Addresses
Primary practice location
50 E North Temple FL 8
Salt Lake City, UT 84150-4412
Mailing address
50 E North Temple FL 8
Salt Lake City, UT 84150-4412
Phone (806) 401-4661
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
| License | State | Type | Specialty |
|---|---|---|---|
| 282730-3902 | UT | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LDS Family Services | Past | 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.
-
- Voluntary or Charitable Agency
- Houston, TX
- NPI 1417006628
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565568000000",
"number": "1497767313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 E NORTH TEMPLE FL 8",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841504412",
"telephone_number": "806-401-4661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 E NORTH TEMPLE FL 8",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841504412",
"telephone_number": "806-401-4661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEVENIN",
"first_name": "KENNETH",
"middle_name": "EUGENE",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2019-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "UT",
"license": "282730-3902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.