MARILEE VANWAGENEN (NPI# 1639630916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639630916 |
| Entity Type | Individual |
| Full Name | MARILEE VANWAGENEN |
| Credential | LCSW |
| Practice Address |
151 S University Ave Ste 3200 Provo UT 84601-4427 |
| Practice Telephone | 8018517128 |
| Mailing Telephone | 8018517128 |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2019-03-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 140473-3501 | UT | Behavioral Health & Social Service Providers |
| Street Address |
151 S UNIVERSITY AVE STE 3200 |
| City | PROVO |
| State | UT |
| Zip Code | 84601-4427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295037521 | Gordon Scott Bruin | Counselor | 151 S University Ave Ste 3200, Provo, UT 84601-4427 | 2010-11-18 |
| 1174145320 | Kirtstynn Selson | Spec/Tech, Pathology | 151 S University Ave Ste 3200, Provo, UT 84601-4427 | 2020-05-11 |
| 1154950046 | Jacob Clay | Case Manager/Care Coordinator | 151 S University Ave Ste 3200, Provo, UT 84601-4427 | 2020-04-03 |
| 1457981797 | Jon Alfredo Ruiz | Licensed Practical Nurse | 151 S University Ave Ste 3200, Provo, UT 84601-4427 | 2020-01-24 |
| 1154967032 | Suzi Smith | Registered Nurse | 151 S University Ave Ste 3200, Provo, UT 84601-4427 | 2019-11-26 |
| 1508401514 | Amanda Calton | Case Manager/Care Coordinator | 151 S University Ave Ste 3200, Provo, UT 84601-4427 | 2019-11-13 |
| 1255974994 | Jared Walker | Case Manager/Care Coordinator | 151 S University Ave Ste 3200, Provo, UT 84601-4427 | 2019-10-25 |
| 1174164370 | Jacob Kuamoo | Case Manager/Care Coordinator | 151 S University Ave Ste 3200, Provo, UT 84601-4427 | 2019-09-30 |
| 1447801543 | Samantha Escamilla | Case Manager/Care Coordinator | 151 S University Ave Ste 3200, Provo, UT 84601-4427 | 2019-09-20 |
| 1871144972 | Angela Roberts | Case Manager/Care Coordinator | 151 S University Ave Ste 3200, Provo, UT 84601-4427 | 2019-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902378417 | 1 Assist Care of Utah Valley LLC | In Home Supportive Care | 180 N University Avenue, Suite 270, Office 213, Provo, UT 84601 | 2018-12-21 |
| 1346723319 | Mp Dental LLC | Dentist | 777 N. 500 W. #204, Proud, UT 84601 | 2018-09-14 |
| 1326530601 | Madison Paige Nelson | Case Manager/Care Coordinator | 750 N Freedom Blvd., Provo, UT 84601 | 2018-06-03 |
| 1245758861 | Annette Roylance | Case Manager/Care Coordinator | 750 North Freedom Boulevard, Suite 300, Provo, UT 84601 | 2017-09-04 |
| 1912422205 | Alexandra Mcbride | Specialist/Technologist | 35 N 300 W #440, Provo, UT 84601 | 2017-08-07 |
| 1932638293 | Audrey Clara Clifton | Case Manager/Care Coordinator | 750 North Freedom Blvd., Provo, UT 84601 | 2017-06-08 |
| 1528514197 | Joseph Hyrum Lewis | Case Manager/Care Coordinator | 750 Freedom Blvd, Provo, UT 84601 | 2016-09-01 |
| 1629427620 | Walker Clements | Case Manager/Care Coordinator | 750 North Freedom Blvd, Provo, UT 84601 | 2016-06-09 |
| 1447611595 | Robert Shirley | Student in an Organized Health Care Education/Training Program | 750 North 200 West, Provo, Ut 84601., Provo, UT 84601 | 2016-03-17 |
| 1700286283 | Brelynn Downs | Student in an Organized Health Care Education/Training Program | 750 North Freedom Blvde, Provo, UT 84601 | 2014-09-03 |
| Find all providers in zip 84601 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487261848 | Jon Nathan Jensen | Counselor | 1025 W 450 N, Provo, UT 84601-2518 | 2020-09-29 |
| 1417439076 | Quin Spencer Volpe | Counselor | 1035 E 560 N, Provo, UT 84606 | 2018-08-30 |
| 1497241905 | Pamela Sue Smith | Counselor | 2696 N University Ave Ste 238, Provo, UT 84604-3848 | 2018-07-09 |
| 1346661600 | Paisley Ann Eddy | Counselor | 717 N 1850 W, Provo, UT 84604 | 2014-01-03 |
| 1760730600 | Sacred Hoop Healing Center | Counselor | 210 W 200 N, Suite 106, Provo, UT 84601-2852 | 2012-08-27 |
| 1518231216 | Mariah Hurst | Counselor | 723 W 1850 N, Provo, UT 84604-1416 | 2012-02-28 |
| 1316229446 | Julia Dumont | Counselor | 715 W 1850 N, Provo, UT 84604-1416 | 2011-09-14 |
| 1750679445 | Karie Swenson | Counselor | 420 Idaho Ave, Provo, UT 84606-5236 | 2011-07-14 |
| 1710290044 | Nicole Cherie Nelson | Counselor | 721 W 1850 N, Provo, UT 84604-1416 | 2010-07-15 |
| 1609189992 | Cynthia Graves | Counselor | 1445 West 1100 North, Provo, UT 84604-6018 | 2010-07-15 |
| Find all providers in PROVO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.