Individual provider Active NPI

Michelle Audrey Sanders, CMHC

  • Mental Health Counselor
  • Taylorsville, UT
National Provider Identifier
1770712291
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
5689 S Redwood Rd
Suite 27
Taylorsville, UT 84123-5447
Phone
(801) 266-2485
Fax
(866) 644-9206
NPI assigned
Jul 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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 Primary

Addresses

Primary practice location

5689 S Redwood Rd
Suite 27
Taylorsville, UT 84123-5447

Mailing address

1592 Spaulding LN
Pocatello, ID 83201-2852
Phone (608) 217-5089

Other practice location 1

1592 Spaulding Ln
Pocatello, ID 83201-2852
Phone (608) 217-5089

Other identifiers 1

IdentifierTypeStateIssuer
7825382-6004OtherUTPROFESSIONAL LICENSE

Other names 1

  • Michelle Audrey Glenetski Former name

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1770712291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1592 SPAULDING LN",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012852",
            "telephone_number": "608-217-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5689 S REDWOOD RD",
            "address_2": "SUITE 27",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841235447",
            "telephone_number": "801-266-2485",
            "fax_number": "866-644-9206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1592 Spaulding Ln",
            "address_purpose": "LOCATION",
            "city": "Pocatello",
            "state": "ID",
            "postal_code": "832012852",
            "country_code": "US",
            "telephone_number": "608-217-5089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "MICHELLE",
        "middle_name": "AUDREY",
        "credential": "CMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-06",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "7825382-6004",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "GLENETSKI",
            "middle_name": "AUDREY",
            "credential": "M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Taylorsville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; 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.