Active NPI
Lamar J Gillen, LPC
- Mental Health Counselor
- Tooele, UT
National Provider Identifier
1902963887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 330366-6004
- Practice address
- 50 N Main St
Tooele, UT 84074-2139 - Phone
- (801) 634-8727
- Fax
- (801) 733-4083
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- 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 | 330366-6004 | UT | Primary |
Addresses
Primary practice location
50 N Main St
Tooele, UT 84074-2139
Mailing address
50 N Main St
Tooele, UT 84074-2139
Phone (801) 634-8727
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 330366-6044 | Other | UT | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 330366-6004 | UT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902963887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 N MAIN ST",
"city": "TOOELE",
"state": "UT",
"postal_code": "840742139",
"telephone_number": "801-634-8727",
"fax_number": "801-733-4083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 N MAIN ST",
"city": "TOOELE",
"state": "UT",
"postal_code": "840742139",
"telephone_number": "801-634-8727",
"fax_number": "801-733-4083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLEN",
"first_name": "LAMAR",
"middle_name": "J",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "UT",
"license": "330366-6004",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "330366-6044",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tooele, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.