Active NPI
Brooke Splain, CMHC
- Mental Health Counselor
- Sandy, UT
National Provider Identifier
1669041604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 11841969-6004
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 11841969-6004 | UT | MD | Mental Health Counselor |
| 11841969-6009 | UT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sage Mountain Counseling | Current | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Sandy, UT
- NPI 1659159432
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.