Individual provider Active NPI

Andrea Shields, PH.D., LMFT

  • Marriage & Family Therapist
  • Murray, UT
National Provider Identifier
1518157882
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
4516 S 700 E Ste 180
Murray, UT 84107-8320
Phone
(801) 824-2862
Fax
(801) 590-8717
NPI assigned
Aug 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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 Primary

Addresses

Primary practice location

4516 S 700 E Ste 180
Murray, UT 84107-8320

Mailing address

4516 S 700 E Ste 180
Murray, UT 84107-8320
Phone (801) 824-2862

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
I20241115002089 UT Practitioner - Marriage and Family Therapist 3375077142 Practice locations: Salt Lake City, UT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1518157882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4516 S 700 E STE 180",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841078320",
            "telephone_number": "801-824-2862",
            "fax_number": "801-590-8717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4516 S 700 E STE 180",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841078320",
            "telephone_number": "801-824-2862",
            "fax_number": "801-590-8717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "ANDREA",
        "name_prefix": "Ms.",
        "credential": "PH.D., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.