NPIMap

Organization Active NPI

Wise Mind Online Therapy

  • Mental Health Counselor
  • Orem, UT
National Provider Identifier
1891398285
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WISE MIND ONLINE THERAPY
Doing business as
Wise Mind Online Therapy
Practice address
915 N 510 E
Orem, UT 84097-3374
Phone
(208) 243-3332
NPI assigned
Nov 18, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Authorized official

Name
Mr. Travis Reed Stephens, LCSW
Title
Owner / Share Holder
Phone
(208) 243-3332

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

915 N 510 E
Orem, UT 84097-3374

Mailing address

915 N 510 E
Orem, UT 84097-3374
Phone (208) 243-3332

Other names 1

  • Wise Mind Online Therapy Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1891398285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 N 510 E",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840973374",
            "telephone_number": "208-243-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N 510 E",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840973374",
            "telephone_number": "208-243-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE MIND ONLINE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "REED",
        "authorized_official_title_or_position": "OWNER / SHARE HOLDER",
        "authorized_official_telephone_number": "208-243-3332",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wise Mind Online Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orem, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.