NPIMap

Organization Active NPI

Radiant Moon, PLLC

Doing business as Kathryn Wingard Creative Counseling

  • Mental Health Counselor
  • Midvale, UT
National Provider Identifier
1811651938
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
RADIANT MOON, PLLC
Doing business as
Kathryn Wingard Creative Counseling
Radiant Mind Wellness
Practice address
940 E South Union Ave
Midvale, UT 84047-2302
Phone
(385) 346-0031
Fax
(385) 446-0973
NPI assigned
Oct 25, 2021
Last updated
Dec 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Kathryn Wingard, LCMHC, ATR-BCNPI 1851921381
Title
Owner/Clinical Director
Phone
(385) 346-0031

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary
Art Therapist 221700000X NU
Adult Mental Health Clinic/Center 261QM0850X NU

Addresses

Primary practice location

940 E South Union Ave
Midvale, UT 84047-2302

Mailing address

5622 S Walden Glen Dr
Salt Lake City, UT 84123-7925
Phone (385) 346-0031

Other names 2

  • Kathryn Wingard Creative Counseling Doing business as
  • Radiant Mind Wellness Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kathryn@kathrynwingardcreativecounseling.com Direct
Direct Messaging Address info@radiantmindwellness.com Direct

National Provider Directory

National Provider Directory

Locations

111 E 5600 S
Ste 200
Salt Lake City, UT 84107
Phone (385) 346-0031

2469 E Fort Union Blvd
Ste 106C
Salt Lake City, UT 84121

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1811651938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5622 S WALDEN GLEN DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841237925",
            "telephone_number": "385-346-0031",
            "fax_number": "385-446-0973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 E SOUTH UNION AVE",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472302",
            "telephone_number": "385-346-0031",
            "fax_number": "385-446-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT MOON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-25",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "WINGARD",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "OWNER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "385-346-0031",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCMHC, ATR-BC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kathryn@kathrynwingardcreativecounseling.com",
            "affiliation": "N",
            "endpointDescription": "business email HIPAA compliant",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "940 E South Union Ave",
            "city": "Midvale",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840472302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@radiantmindwellness.com",
            "affiliation": "N",
            "endpointDescription": "business email HIPAA compliant",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "940 E South Union Ave",
            "city": "Midvale",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840472302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kathryn Wingard Creative Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kathryn Wingard Creative Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Radiant Mind Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midvale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.