Veronica Malencia
Individual provider Active NPI Mental Health Counselor · Loa, UT
NPI 1649816638 · NPPES record last updated Nov 25, 2019
Key facts
- NPI
- 1649816638
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 11511529-6009 (UT)
- Practice address
- 1764 W Aspen Lane
Loa, UT 84747 - Phone
- (435) 836-2272
- NPI assigned
- Nov 25, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
321 N Mall Dr
St George, UT 84790-7302
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11511529-6009 | UT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Enlightened Counseling Services LLC | Past |
Accepting new patients | |
| Legacy Treatment Center LLC | Past |
Accepting new patients | |
| Juniper Canyon Recovery Center for Women, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 11511529-6009 | UT | Yes |
Addresses
Primary practice location
1764 W Aspen Lane
Loa, UT 84747
Mailing address
520 N Aspen Road
Loa, UT 84747
Other providers in Loa, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.