Kathryn Wingard, LCMHC, ATR-BC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10178806-6004 Issued in UT

Practice address

940 E South Union Ave
Midvale, UT 84047-2302

Phone

(385) 346-0031

Fax

(385) 446-0973

NPI assigned

Jan 23, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Radiant Moon, PLLC

  • Mental Health Counselor
  • Midvale, UT
  • NPI 1811651938
  NPD Authorized official

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1851921381",
    "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"
        },
        {
            "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": {
        "last_name": "WINGARD",
        "first_name": "KATHRYN",
        "credential": "LCMHC, ATR-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Art Therapist",
            "state": null,
            "license": "17-277",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "10178806-6004",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Jeffery Williams, MD
• Janet L Williams, PA-C
• Erin J Wilson
• Reggie D Wilson, LCSW
• Scott Wiltbank
• Parker James Wininger
• Julie Hoggard Winn
• Barbara R Wong, R.N.
• Karen Joy Wong, LCSW
• Margaret Wood-McIver, LPN

• Mental Health Counselor in Midvale, UT
• Providers in Midvale, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.