Tysa Slade, LAMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

727 E 1100 S
Mapleton, UT 84664-5016

Phone

(801) 602-8336

NPI assigned

Mar 3, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Maple Mountain Recovery

  • Substance Abuse Rehabilitation Facility
  • Mapleton, UT
  • NPI 1174948079
  NPD (past)

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1689209355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 E 1100 S",
            "city": "MAPLETON",
            "state": "UT",
            "postal_code": "846645016",
            "telephone_number": "801-602-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 E 1100 S",
            "city": "MAPLETON",
            "state": "UT",
            "postal_code": "846645016",
            "telephone_number": "801-602-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLADE",
        "first_name": "TYSA",
        "credential": "LAMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-03",
        "last_updated": "2023-11-27",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "tslade@maplemountainrecovery.com",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "Maple Mountain Recovery",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "727 E 1100 S",
            "city": "Mapleton",
            "state": "UT",
            "country_code": "US",
            "postal_code": "846645016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• PDC Mapleton LLC
• Derrick Evan Pickering, N.P.
• Procare Therapy, Inc.
• Rocky Mountain Care - Mapleton Manager LLC
• Summer Simmons
• Gillan Maclean Smith, PH.D.
• Stellify Trauma Therapy
• Stonehaven Dental - Mapleton LLC
• Stonehenge Care LLC
• Sundance Dermatology, LLC

• All providers in Mapleton, UT
• Marriage & Family Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.