Individual provider Active NPI

Brooke Splain, CMHC

  • Mental Health Counselor
  • Sandy, UT
National Provider Identifier
1669041604
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11841969-6004 Issued in UT
Practice address
740 E 9000 S Ste a
Sandy, UT 84094-3077
Phone
(801) 930-0121
NPI assigned
Jun 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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 11841969-6009 UT
Mental Health Counselor 101YM0800X 11841969-6004 UT Primary

Addresses

Primary practice location

740 E 9000 S Ste a
Sandy, UT 84094-3077

Mailing address

1848 E Peyton CT
Holladay, UT 84117-5654
Phone (310) 213-1044

Other practice location 1

1291 W 12600 S
Riverton, UT 84065-7098
Phone (801) 930-0121

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.sagemoutainutah.com

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
11841969-6004UTMDMental Health Counselor
11841969-6009UTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Mountain Counseling CurrentSince Sep 24, 2023 Accepting new patients

Locations

740 E 9000 S
Ste A
Sandy, UT 84094
Phone (801) 708-4099

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": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1669041604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1848 E PEYTON CT",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841175654",
            "telephone_number": "310-213-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 E 9000 S STE A",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840943077",
            "telephone_number": "801-930-0121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1291 W 12600 S",
            "address_purpose": "LOCATION",
            "city": "Riverton",
            "state": "UT",
            "postal_code": "840657098",
            "country_code": "US",
            "telephone_number": "801-930-0121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPLAIN",
        "first_name": "BROOKE",
        "credential": "CMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "11841969-6009",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "11841969-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.sagemoutainutah.com",
            "affiliation": "N",
            "address_1": "740 E 9000 S Ste A",
            "city": "Sandy",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840943077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Dec 21, 2022; 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.