Ivy Christiansen, LMFT

Individual provider Active NPI Marriage & Family Therapist · Herriman, UT

NPI 1831804087 · NPPES record last updated Oct 30, 2023

Key facts

NPI
1831804087
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
122600593902 (UT)
Practice address
4924 W Desert Sage Dr
Herriman, UT 84096-3436
Phone
(801) 906-1074
NPI assigned
Jan 20, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
122600593902UTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Children Deserve More Current
since Nov 5, 2023
Accepting new patients
Rosecrest Mental Health PLLC Current Accepting new patients
Willow Therapy Services, LLC Marriage & Family Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 122600593902 UT Yes

Addresses

Primary practice location

4924 W Desert Sage Dr
Herriman, UT 84096-3436

Mailing address

4924 W Desert Sage Dr
Herriman, UT 84096-3436

Other providers in Herriman, UT

All providers in Herriman, UT · Marriage & Family Therapist in Utah

Sources for this page

Verify at the official NPI Registry.