Kaelie Noel Lemmon

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

12310278-3902 Issued in UT

Practice address

1675 N Freedom Blvd Ste 10B
Provo, UT 84604-6906

Phone

(801) 900-6056

NPI assigned

Aug 6, 2017

Last updated

Oct 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kaelie Noel Wagner Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1501977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1871018333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 N FREEDOM BLVD STE 10B",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046906",
            "telephone_number": "801-900-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 N FREEDOM BLVD STE 10B",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046906",
            "telephone_number": "801-900-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMMON",
        "first_name": "KAELIE",
        "middle_name": "NOEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-06",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "12310278-3902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Orem",
            "affiliation": "N",
            "address_1": "1426 E 820 N",
            "city": "Orem",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840975481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KAELIE",
            "last_name": "WAGNER",
            "middle_name": "NOEL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Katrina Leigh
• Alexandra Leininger, LCSW
• Craig Leishman
• Michael David Leman, N.P.
• Katherine Lemke, NP
• Sherry Nikole Lemmon
• Kate Elizabeth Lengal
• Maria Carmen Leri, M.F.T.I.
• McKayla Norene Lesa
• Robert T Lesa, PA

• Marriage & Family Therapist in Provo, UT
• Providers in Provo, UT by specialty
• Marriage & Family Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.