Maggi Leavitt, LMFT

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

43 E 640 S
Ephraim, UT 84627-3029

Phone

(801) 427-5436

Fax

(801) 427-5436

NPI assigned

Jul 8, 2013

Last updated

Mar 17, 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 2

Addresses

Other names 1

• Maggi Quackenbush Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 23, 2024 through Jan 23, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Life Enhancement Center

  • Community/Behavioral Health Agency
  • Provo, UT
  • NPI 1083876734
  NPD (past)
• Life Enhancement Center

  • Adult Mental Health Clinic/Center
  • Provo, UT
  • NPI 1326304023
  NPD (past)

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1629419593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 E 640 S",
            "city": "EPHRAIM",
            "state": "UT",
            "postal_code": "846273029",
            "telephone_number": "801-427-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 E 640 S",
            "city": "EPHRAIM",
            "state": "UT",
            "postal_code": "846273029",
            "telephone_number": "801-427-5436",
            "fax_number": "801-427-5436"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1835 N 1120 W",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846041180",
            "country_code": "US",
            "telephone_number": "801-623-4770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEAVITT",
        "first_name": "MAGGI",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "5040273-3902",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAGGI",
            "last_name": "QUACKENBUSH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rhett C. Larsen, LCSW
• Justin Larson
• Matthew Alof Larson, CMHC
• Matthew H Larson
• Catherine Ann Leatham, BACHELOR OF SCIENCE
• Lighthouse Ranch Corporation
• Jennifer Rose Livingston
• Jonatan Lopez Mancilla
• Chet Riley Ludlow, CSWI
• Kristofer Lundeberg, LCSW

• Case Manager/Care Coordinator in Ephraim, UT
• Providers in Ephraim, UT by specialty
• Case Manager/Care Coordinator in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.