Active NPI
Carole Mounteer Kamradt, LCSW
- Mental Health Counselor
- South Jordan, UT
National Provider Identifier
1780035501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 7687208-3501
- Practice address
- 1258 W South Jordan Pkwy
Suite 202
South Jordan, UT 84095-4711 - Phone
- (801) 255-1155
- NPI assigned
- Jun 22, 2016
- Sex
- Female
- Sole proprietor
- No
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 | 7687208-3501 | UT | Primary |
Addresses
Primary practice location
1258 W South Jordan Pkwy
Suite 202
South Jordan, UT 84095-4711
Mailing address
1258 W South Jordan Pkwy
Suite 202
South Jordan, UT 84095-4711
Phone (801) 255-1155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 1, 2024 through May 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7687208-3501 | UT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suncrest Counseling | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- South Jordan, UT
- NPI 1902232085
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466553600000",
"number": "1780035501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1258 W SOUTH JORDAN PKWY",
"address_2": "SUITE 202",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840954711",
"telephone_number": "801-255-1155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1258 W SOUTH JORDAN PKWY",
"address_2": "SUITE 202",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840954711",
"telephone_number": "801-255-1155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAMRADT",
"first_name": "CAROLE",
"middle_name": "MOUNTEER",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-22",
"last_updated": "2016-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "UT",
"license": "7687208-3501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.