Active NPI
Torrence Wimbish
- Mental Health Counselor
- Salt Lake City, UT
National Provider Identifier
1770949505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 5758872-6004
- Practice address
- 4943 S Wasatch Blvd
Salt Lake City, UT 84124-4798 - Phone
- (801) 449-0089
- NPI assigned
- Jan 8, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 5758872-6004 | UT | Primary |
Addresses
Primary practice location
4943 S Wasatch Blvd
Salt Lake City, UT 84124-4798
Mailing address
1260 W 900 N
Salt Lake City, UT 84116-3818
Phone (801) 388-3001
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 |
|---|---|---|---|
| 5758872-6004 | UT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eva Carlston Academy | Past | Accepting new patients | |
| Vivid Safe House | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- Salt Lake City, UT
- NPI 1427330968
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Salt Lake City, UT
- NPI 1043070063
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452211200000",
"number": "1770949505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1260 W 900 N",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841163818",
"telephone_number": "801-388-3001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4943 S WASATCH BLVD",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841244798",
"telephone_number": "801-449-0089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIMBISH",
"first_name": "TORRENCE",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-01-08",
"last_updated": "2016-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "UT",
"license": "5758872-6004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.