Individual provider Active NPI

Misty June Newman, CMHC

  • Mental Health Counselor
  • South Jordan, UT
National Provider Identifier
1932457611
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8667946-6004 Issued in UT
Practice address
10393 S Temple Dr Ste 103
South Jordan, UT 84095-8883
Phone
(801) 236-3892
Fax
(801) 236-3890
NPI assigned
Aug 28, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 8667946-6004 UT Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

10393 S Temple Dr Ste 103
South Jordan, UT 84095-8883

Mailing address

10393 S Temple Dr Ste 103
South Jordan, UT 84095-8883
Phone (801) 236-3892

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 2, 2024 through Jan 2, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8667946-6004UTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Valley Counseling, LLC Mental Health CurrentSince Aug 2, 2020 Accepting new patients
Volunteers of America Past Accepting new patients

Locations

10393 S Temple Dr
Ste 103
South Jordan, UT 84095
Phone (801) 236-3892

10434 S 1055 W
Ste 101
South Jordan, UT 84095
Phone (435) 565-1305

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1932457611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10393 S TEMPLE DR STE 103",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958883",
            "telephone_number": "801-236-3892",
            "fax_number": "801-236-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10393 S TEMPLE DR STE 103",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958883",
            "telephone_number": "801-236-3892",
            "fax_number": "801-236-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "MISTY",
        "middle_name": "JUNE",
        "credential": "CMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "8667946-6004",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

Verify at the official NPI Registry.