Active NPI
Miriam E Gunn, LMFT
- Marriage & Family Therapist
- Logan, UT
National Provider Identifier
1821383241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 7127088-3902
- Practice address
- 965 S 100 W Ste 203
Logan, UT 84321-6071 - Phone
- (435) 752-1976
- Fax
- (435) 755-6707
- NPI assigned
- Jun 14, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 7127088-3902 | UT | Primary |
Addresses
Primary practice location
965 S 100 W Ste 203
Logan, UT 84321-6071
Mailing address
965 S 100 W Ste 203
Logan, UT 84321-6071
Phone (435) 752-1976
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 6, 2024 through Mar 6, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7127088-3902 | UT | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308009600000",
"number": "1821383241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "965 S 100 W STE 203",
"city": "LOGAN",
"state": "UT",
"postal_code": "843216071",
"telephone_number": "435-752-1976",
"fax_number": "435-755-6707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "965 S 100 W STE 203",
"city": "LOGAN",
"state": "UT",
"postal_code": "843216071",
"telephone_number": "435-752-1976",
"fax_number": "435-755-6707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUNN",
"first_name": "MIRIAM",
"middle_name": "E",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-14",
"last_updated": "2011-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "UT",
"license": "7127088-3902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.