Sunny Lee Nielsen, CMHC

Key facts

NPI

1760143630

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

License

5265255-6009 (UT)

Practice address

20428 W 6250 N
Mountain Home, UT 84051-8405

Phone

(801) 209-6108

NPI assigned

Jan 4, 2022

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 4, 2022.

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1760143630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 65 BOX 510008",
            "city": "MOUNTAIN HOME",
            "state": "UT",
            "postal_code": "840519700",
            "telephone_number": "801-209-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20428 W 6250 N",
            "city": "MOUNTAIN HOME",
            "state": "UT",
            "postal_code": "840518405",
            "telephone_number": "801-209-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "SUNNY",
        "middle_name": "LEE",
        "credential": "CMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "5265255-6009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}