Active NPI
Angie Suzanne Hendren
- Professional Counselor
- Sandy, UT
National Provider Identifier
1649225533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 33024-6004
- Practice address
- 731 E 8600 S
Sandy, UT 84094-6312 - Phone
- (801) 561-9987
- Fax
- (801) 561-9987
- NPI assigned
- May 23, 2006
- Last updated
- Oct 10, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 33024-6004 | UT | Primary |
Addresses
Primary practice location
731 E 8600 S
Sandy, UT 84094-6312
Mailing address
4973 Bridle Creek Dr
West Jordan, UT 84081-3667
Phone (801) 455-8958
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33020460001001 | Other | UT | REGENCE PROVIDER ID |
| 870476172-008 | Other | UT | VALLEY MENTAL HEALTH |
| 89204 | Other | UT | PEHP PROVIDER ID |
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 |
|---|---|---|---|
| 33024-6004 | UT | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shepherds Staff Christian Counseling Center Inc | Professional | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Christian Counseling Centers of Utah
- Clinical Psychologist
- Midvale, UT
- NPI 1558395525
Professional
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223596800000",
"number": "1649225533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4973 BRIDLE CREEK DR",
"city": "WEST JORDAN",
"state": "UT",
"postal_code": "840813667",
"telephone_number": "801-455-8958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "731 E 8600 S",
"city": "SANDY",
"state": "UT",
"postal_code": "840946312",
"telephone_number": "801-561-9987",
"fax_number": "801-561-9987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDREN",
"first_name": "ANGIE",
"middle_name": "SUZANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-23",
"last_updated": "2008-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "UT",
"license": "33024-6004",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE PROVIDER ID",
"identifier": "33020460001001",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALLEY MENTAL HEALTH",
"identifier": "870476172-008",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEHP PROVIDER ID",
"identifier": "89204",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sandy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.