Active NPI
Kristine Conklin Naylor, CMHC
- Mental Health Counselor
- Tooele, UT
National Provider Identifier
1982940276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 5462396-6004
- Practice address
- 804 W 620 S
Tooele, UT 84074 - Phone
- (435) 841-9063
- NPI assigned
- Dec 14, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Mental Health Counselor | 101YM0800X | 5462396-6004 | UT | Primary |
Addresses
Primary practice location
804 W 620 S
Tooele, UT 84074
Mailing address
804 W 620 S
Tooele, UT 84074
Phone (435) 841-9063
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 |
|---|---|---|---|
| 5462396-6004 | UT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659052800000",
"number": "1982940276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 W 620 S",
"city": "TOOELE",
"state": "UT",
"postal_code": "84074",
"telephone_number": "435-841-9063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 W 620 S",
"city": "TOOELE",
"state": "UT",
"postal_code": "84074",
"telephone_number": "435-841-9063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAYLOR",
"first_name": "KRISTINE",
"middle_name": "CONKLIN",
"credential": "CMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-14",
"last_updated": "2022-07-29",
"certification_date": "2022-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "UT",
"license": "5462396-6004",
"primary": true
}
],
"identifiers": [],
"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 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.