Annelise Allen
Individual provider Active NPI Mental Health Counselor · Murray, UT
NPI 1922464585 · NPPES record last updated Jul 16, 2025
Key facts
- NPI
- 1922464585
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 11336132-6009 (UT)
- Practice address
- 4516 S 700 E Ste 170
Murray, UT 84107-8320 - Phone
- (801) 702-0834
- NPI assigned
- Jan 12, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Confederated Tribes of the Goshute Reservation
Practice addresses (Care Compare)
660 S 200
Suite 250
Salt Lake City, UT 84111-3846
660 S 200 E
Salt Lake, UT 84111-3846
Phone (801) 395-2256
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251028003018 | TX | Practitioner - Mental Health Counselor | 3971955261 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11336132-6009 | UT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Confederated Tribes of the Goshute Reservation | Current |
Accepting new patients | |
| Confederated Tribes of the Goshute Reservation | Current |
Accepting new patients | |
| Annelise Allen Counseling Services PLLC | Community/Behavioral Health | Current | Accepting new patients |
Locations
195 Tribal Center Rd
Ibapah, UT 84034
Phone (435) 234-1302
660 S 200 E
Slc, UT 84111
Phone (801) 355-1528
660 S 200 E
Ste 250
Slc, UT 84111
Phone (801) 395-2256
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | 11336132-6009 | UT | Yes |
Addresses
Primary practice location
4516 S 700 E Ste 170
Murray, UT 84107-8320
Mailing address
4516 S 700 E Ste 170
Murray, UT 84107-8320
Phone (801) 702-0834
Other practice location 1
660 S 200 E
Salt Lake City, UT 84111-3835
Phone (801) 359-2256
Other providers in Murray, UT
- Jared Blake Allan
- Jonathan Allan
- Spencer Kendall Allan
- Allen R Groebs MD PC
- Amy Allen
- Darin Allen
- Thomas Allen
- Yolanda M Allen
- Alliance Medical Center LLC
- Samantha Allison
All providers in Murray, UT · Mental Health Counselor in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.