Individual provider Active NPI

Amanda Van Ausdal

  • Mental Health Counselor
  • West Valley City, UT
National Provider Identifier
1700123635
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
9054924-6004 Issued in UT
Practice address
3737 W 4100 S Suite 100
West Valley City, UT 84120
Phone
(801) 548-0079
NPI assigned
Jan 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 9054924-6004 UT Primary

Addresses

Primary practice location

3737 W 4100 S Suite 100
West Valley City, UT 84120

Mailing address

4460 S Highland Dr
Salt Lake City, UT 84124-3543
Phone (888) 949-4864

Other practice location 1

350 E 2100 S
Salt Lake City, UT 84115-2266
Phone (801) 428-3447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250428003512 UT Practitioner - Mental Health Counselor 6103342605 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Mental Health Incorporated Current Accepting new patients
Valley Behavioral Health Incorporated CurrentSince Mar 3, 2025 Accepting new patients

Locations

4460 S Highland Dr
Ste 100
Salt Lake City, UT 84124
Phone (801) 273-1085

4460 S Highland Dr
Ste 210
Salt Lake City, UT 84124
Phone (801) 273-6311

4460 S Highland Dr
Ste 230
Slc, UT 84124
Phone (801) 263-7227

4460 S Highland Dr
Slc, UT 84124
Phone (801) 263-7101

Organizations & group practices 2

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": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1700123635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 S HIGHLAND DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841243543",
            "telephone_number": "888-949-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 W 4100 S SUITE 100",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "84120",
            "telephone_number": "801-548-0079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 E 2100 S",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841152266",
            "country_code": "US",
            "telephone_number": "801-428-3447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN AUSDAL",
        "first_name": "AMANDA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "9054924-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

Verify at the official NPI Registry.