AMBER B WILLIS (PH.D., LMFT) – Marriage & Family Therapist, NPI 1316275274

AMBER B WILLIS (PH.D., LMFT) is a healthcare provider. based in Salt lake city, Utah. specializing in MARRIAGE AND FAMILY THERAPIST. They hold the professional credentials PH.D., LMFT. They hold a License No. 334196-3904 (UT). The NPI Number for AMBER B WILLIS (PH.D., LMFT) is 1316275274

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
AMBER B WILLIS (PH.D., LMFT)
NPI
1316275274
Phone
(801) 693-1192
Address
986 W ATHERTON DR
Enumeration Date
3 December 2009
Last Update Date
27 April 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8016839340
Graduation Year
2004 (22 years ago)
PAC ID
2769800895
Group Practice PAC ID
6800030727
Professional Enrollment ID
I20250106003284
Address ID
UT840106249BO270XXSTXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:16State licenses:1Digital endpointsOther names

148 MARRIAGE AND FAMILY THERAPIST in UT

Provider Addresses for AMBER B WILLIS (PH.D., LMFT)

  • 986 W ATHERTON DR

    270

    SALT LAKE CITY, UT 841236887

    Phone: (801) 693-1192

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-01-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250106003284IMarriage And Family TherapistUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84123)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6800030727View full group profile
NameSpecialtyState
Clinical Social WorkerUT
Clinical Social WorkerUT
Clinical Social WorkerUT
Nurse PractitionerUT

Reviews

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Frequently asked questions

How is AMBER B WILLIS (PH.D., LMFT) identified in CMS data?
CMS-hosted NPPES data lists AMBER B WILLIS (PH.D., LMFT) with NPI 1316275274.
Can I rely on AMBER B WILLIS (PH.D., LMFT) being an active provider?
As of the registry snapshot, AMBER B WILLIS (PH.D., LMFT) is marked active.
What is AMBER B WILLIS (PH.D., LMFT)'s primary classification?
Marriage & Family Therapist is the headline specialty for AMBER B WILLIS (PH.D., LMFT) here. Clinical services aligned with this taxonomy classification.
What area does AMBER B WILLIS (PH.D., LMFT) serve?
AMBER B WILLIS (PH.D., LMFT)'s listing highlights Salt Lake City, Utah; more addresses can appear in NPPES.
Why does AMBER B WILLIS (PH.D., LMFT) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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