Active NPI
Michael Mortensen
- Counselor
- Brigham City, UT
National Provider Identifier
1992103402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 862 S Main St Ste 4
Brigham City, UT 84302-3389 - Phone
- (435) 723-1799
- NPI assigned
- Dec 16, 2014
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
862 S Main St Ste 4
Brigham City, UT 84302-3389
Mailing address
862 S Main St Ste 4
Brigham City, UT 84302-3389
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peace Balance and Joy Consulting | Past | Accepting new patients |
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.
-
- Mental Health Counselor
- Enoch, UT
- NPI 1366905614
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418688000000",
"number": "1992103402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "862 S MAIN ST STE 4",
"city": "BRIGHAM CITY",
"state": "UT",
"postal_code": "843023389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "862 S MAIN ST STE 4",
"city": "BRIGHAM CITY",
"state": "UT",
"postal_code": "843023389",
"telephone_number": "435-723-1799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTENSEN",
"first_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-12-16",
"last_updated": "2014-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brigham City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.