Individual provider Active NPI

Nichole Patrick, LCMHC

  • Mental Health Counselor
  • Riverton, UT
National Provider Identifier
1962640987
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13232106-6004 Issued in UT
Practice address
13222 Tree Sparrow Dr Ste R210
Riverton, UT 84096-2889
Phone
(801) 872-5516
NPI assigned
Jan 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 13232106-6004 UT Primary

Addresses

Primary practice location

13222 Tree Sparrow Dr Ste R210
Riverton, UT 84096-2889

Mailing address

9041 S Liberty Bend Dr
Sandy, UT 84094-4083
Phone (971) 329-9717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260511003178 UT Practitioner - Mental Health Counselor 1355819004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascendant Behavioral Health LLCGroup PAC ID 1850673187, 62 clinicians

Practice addresses (Care Compare)

13222 Tree Sparrow Dr
Suite R210
Riverton, UT 84096-2889
Phone (801) 872-5516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13232106-6004UTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ascendant Behavioral Health LLC CurrentSince Aug 10, 2025 Accepting new patients

Locations

13222 Tree Sparrow Dr
Ste R210
Riverton, UT 84096

Organizations & group practices 1

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": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1962640987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9041 S LIBERTY BEND DR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840944083",
            "telephone_number": "971-329-9717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13222 TREE SPARROW DR STE R210",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840962889",
            "telephone_number": "801-872-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "NICHOLE",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "13232106-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

Verify at the official NPI Registry.