Active NPI
Deanna R Nichols, LCMHC, RDN
- Counselor
- Sandy, UT
National Provider Identifier
1750649265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 278841-6004
- Practice address
- 11075 S State St Ste 14
Sandy, UT 84070-5194 - Phone
- (801) 580-0552
- NPI assigned
- May 3, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 278841-6004 | UT | Primary |
| Registered Dietitian | 133V00000X | 278841-4901 | UT |
Addresses
Primary practice location
11075 S State St Ste 14
Sandy, UT 84070-5194
Mailing address
1791 E Mule Deer Dr
Draper, UT 84020-5625
Phone (801) 580-0552
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 |
|---|---|---|---|
| 278841-6004 | UT | MD | Counselor |
| 278841-4901 | UT | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458086400000",
"number": "1750649265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1791 E MULE DEER DR",
"city": "DRAPER",
"state": "UT",
"postal_code": "840205625",
"telephone_number": "801-580-0552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11075 S STATE ST STE 14",
"city": "SANDY",
"state": "UT",
"postal_code": "840705194",
"telephone_number": "801-580-0552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "DEANNA",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "LCMHC, RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-03",
"last_updated": "2016-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "UT",
"license": "278841-6004",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "UT",
"license": "278841-4901",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"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 Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.