NPI Code Detail JSON Logo

1003732892 NPI number — REBECCA MALIA EDWARDS ACMHC

NPI Number: 1003732892
Health Care Provider/Practitioner: REBECCA MALIA EDWARDS ACMHC

Information about “1003732892” NPI (REBECCA MALIA EDWARDS ACMHC) exists in 1003732892 in HTML format HTML  |  1003732892 in plain Text format TXT  |  1003732892 in PDF (Portable Document Format) PDF  |  1003732892 in an XML format XML  formats.

NPI Number : 1003732892 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1003732892",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "EDWARDS",
    "FirstName": "REBECCA",
    "MiddleName": "MALIA",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "ACMHC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "EDWARDS",
    "OtherFirstName": "BECKY",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "ACMHC",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "1875 S 2265 W",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SYRACUSE",
    "MailingAddressStateName": "UT",
    "MailingAddressPostalCode": "84075-7108",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "801-820-0939",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1371 N 1075 W STE 5",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FARMINGTON",
    "PracticeLocationAddressStateName": "UT",
    "PracticeLocationAddressPostalCode": "84025-2810",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "801-820-0939",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/25/2026",
    "LastUpdateDate": "06/25/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YM0800X",
        "TaxonomyName": "Mental Health Counselor",
        "LicenseNumber": "14268072-6009",
        "LicenseNumberStateCode": "UT",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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