Individual provider Active NPI

Corinna Fitzwater, CMHC

  • Mental Health Counselor
  • Millcreek, UT
National Provider Identifier
1700567799
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11291192-6004 Issued in UT
Practice address
1398 E Luck LN
Millcreek, UT 84106-2944
Phone
(801) 251-6767
NPI assigned
Jul 31, 2023
Last updated
Jul 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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 11291192-6004 UT Primary

Addresses

Primary practice location

1398 E Luck LN
Millcreek, UT 84106-2944

Mailing address

4659 S Quail Vista LN Apt K
Salt Lake City, UT 84117-4864
Phone (801) 971-4866

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
11291192-6004UTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Woodhaven at Millcreek Psychotherapy Services Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1700567799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4659 S QUAIL VISTA LN APT K",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174864",
            "telephone_number": "801-971-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1398 E LUCK LN",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841062944",
            "telephone_number": "801-251-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZWATER",
        "first_name": "CORINNA",
        "credential": "CMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "11291192-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millcreek, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.