Individual provider Active NPI

Isaac A Vazquez, CMHC, LMFT

  • Mental Health Counselor
  • Provo, UT
National Provider Identifier
1528490760
Registry record updated Mar 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11009876-6004 Issued in UT
Practice address
379 N University Ave Ste 300
Provo, UT 84601-2878
Phone
(801) 341-9521
NPI assigned
Jul 30, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 11009876-6004 UT Primary
Marriage & Family Therapist 106H00000X 11009876-3902 UT

Addresses

Primary practice location

379 N University Ave Ste 300
Provo, UT 84601-2878

Mailing address

4076 E South Pass Rd
Eagle Mountain, UT 84005-6049
Phone (801) 341-9521

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

LicenseStateTypeSpecialty
11009876-6004UTMDMental Health Counselor
11009876-3902UTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Words of Wisdom Counseling Mental Health CurrentSince Mar 12, 2024 Accepting new patients

Locations

11440 Okeechobee Blvd
Ste 210
Royal Palm Beach, FL 33411
Phone (561) 293-7003

379 N University Ave
Ste 300
Provo, UT 84601
Phone (385) 455-3768

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": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709942400000",
    "number": "1528490760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4076 E SOUTH PASS RD",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840056049",
            "telephone_number": "801-341-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 N UNIVERSITY AVE STE 300",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846012878",
            "telephone_number": "801-341-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "ISAAC",
        "middle_name": "A",
        "credential": "CMHC, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-30",
        "last_updated": "2024-03-09",
        "certification_date": "2024-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "11009876-6004",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "11009876-3902",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.