Individual provider Active NPI

Amanda Nelson

  • Marriage & Family Therapist
  • Salt Lake City, UT
National Provider Identifier
1821453986
Registry record updated Dec 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
8650445-3905 Issued in UT
Practice address
2150 S McClelland St
Apt 217
Salt Lake City, UT 84106-2580
Phone
(801) 815-5855
NPI assigned
Dec 16, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 8650445-3905 UT Primary

Addresses

Primary practice location

2150 S McClelland St
Apt 217
Salt Lake City, UT 84106-2580

Mailing address

2150 S McClelland St
Apt 217
Salt Lake City, UT 84106-2580
Phone (801) 815-5855

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

LicenseStateTypeSpecialty
8650445-3905UTMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1450224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450224000000",
    "number": "1821453986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 S MCCLELLAND ST",
            "address_2": "APT 217",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062580",
            "telephone_number": "801-815-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 S MCCLELLAND ST",
            "address_2": "APT 217",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062580",
            "telephone_number": "801-815-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-16",
        "last_updated": "2015-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "8650445-3905",
            "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 Dec 16, 2015; 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.