Carly Brooke Snow, MA, AMFT, 1000-ERYT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

10836864-3904 Issued in UT

Practice address

4624 S Holladay Blvd
Holladay, UT 84117-7054

Phone

(801) 558-5950

NPI assigned

Jul 31, 2018

Last updated

Jul 31, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rocky Mountain University of Health Professions Foundation

  • Physical Therapist
  • Provo, UT
  • NPI 1053174417
  Medicare reassignment NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  UT

  Medicare reassignment
• Rocky Mountain University Health Center

  • Optometrist
  • SLC, UT
  • NPI 1861141822
  NPD

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1588142608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4624 S HOLLADAY BLVD",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841177054",
            "telephone_number": "609-313-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4624 S HOLLADAY BLVD",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841177054",
            "telephone_number": "801-558-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOW",
        "first_name": "CARLY",
        "middle_name": "BROOKE",
        "name_prefix": "Ms.",
        "credential": "MA, AMFT, 1000-ERYT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "10836864-3904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J. Richard Smart, D.D.S.
• Douglas Roland Smith, M.D.
• James Kimball Smith, LCSW
• Noni Smith, COTA
• Stephen B Smith, MD
• Madison McGregor Snow
• Steven B Soelbert, DMD
• Speech Superstars
• Bruce Warelo Sperry, PT, PA-C
• Standard Optical Co

• Marriage & Family Therapist in Holladay, UT
• Providers in Holladay, UT by specialty
• Marriage & Family Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.