Blake Thomas Halliday, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

5989003-3902 Issued in UT

Practice address

5149 S 1500 W
Riverdale, UT 84405-3926

Phone

(801) 475-0402

Fax

(801) 475-7464

NPI assigned

Oct 18, 2006

Last updated

Jan 4, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 3, 2026 through Feb 3, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1710068473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5149 S 1500 W",
            "city": "RIVERDALE",
            "state": "UT",
            "postal_code": "844053926",
            "telephone_number": "801-475-0402",
            "fax_number": "801-475-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5149 S 1500 W",
            "city": "RIVERDALE",
            "state": "UT",
            "postal_code": "844053926",
            "telephone_number": "801-475-0402",
            "fax_number": "801-475-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLIDAY",
        "first_name": "BLAKE",
        "middle_name": "THOMAS",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "5989003-3902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "260022408",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "876000308007",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Griffiths
• Melissa Grace Grogan, RBT
• Andrea Christine Gunnerson, RPH
• Mark Henry Habermeyer, DDS
• Nickolas Theo Hadley
• Amber Hancock, ATC, LAT
• Hadley Handsaker
• Anastasia L Haner, CPM, LM
• Nathan Hansen
• Ryley Hansen

• Marriage & Family Therapist in Riverdale, UT
• Providers in Riverdale, UT by specialty
• Marriage & Family Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.