Active NPI
Alyssa Jane Banford Witting, PHD, LMFT
- Mental Health Counselor
- Provo, UT
National Provider Identifier
1891207643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 8880108-3902
- Practice address
- 1190 N 900 E
Provo, UT 84604-3536 - Phone
- (801) 422-6767
- NPI assigned
- Nov 2, 2017
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 8880108-3902 | UT | Primary |
Addresses
Primary practice location
1190 N 900 E
Provo, UT 84604-3536
Mailing address
1190 N 900 E
Provo, UT 84604-3536
Phone (801) 422-6767
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 29, 2024 through Jan 29, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8880108-3902 | UT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509580800000",
"number": "1891207643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1190 N 900 E",
"city": "PROVO",
"state": "UT",
"postal_code": "846043536",
"telephone_number": "801-422-6767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1190 N 900 E",
"city": "PROVO",
"state": "UT",
"postal_code": "846043536",
"telephone_number": "801-422-6767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTING",
"first_name": "ALYSSA",
"middle_name": "JANE BANFORD",
"name_prefix": "Dr.",
"credential": "PHD, LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-02",
"last_updated": "2017-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "UT",
"license": "8880108-3902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2017; 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.