1. Home
  2. Directory
  3. Utah
  4. Slc
  5. Counselor
  6. NPI Profile

CHARLES L DIVINEY III MC LPC NCC LLC
NPI 1235447772
Counselor - Professional in Slc, UT

Active since September 17, 2010
352 S DENVER ST STE 350, SLC, UT 84111(801) 521-4227(801) 359-0777 Get Directions Write a Review

NPPES record last updated: October 2, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Charles L Diviney Iii Mc Lpc Ncc Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLES L DIVINEY III MC LPC NCC LLC (NPI 1235447772) is a healthcare organization registered as a professional in Slc, Utah and active in the NPI registry since September 2010. The organization lists Debra Morrill, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1235447772
Entity TypeOrganization
Primary Taxonomy101YP2500X
Legal Business NameCHARLES L DIVINEY III MC LPC NCC LLC
Location Address352 S DENVER ST STE 350Slc, UT 84111-3059
Mailing AddressPo Box 3872Slc, UT 84110-3872 · (801) 521-4227 · Fax (801) 359-0777
Phone(801) 521-4227
Fax(801) 359-0777
Organization SubpartNo
Authorized OfficialDebra MorrillBilling Manager · (801) 916-1645
Enumeration DateSeptember 17, 2010
Last NPPES UpdateOctober 2, 2025
NPPES CertifiedOctober 2, 2025
✔ NPI 1235447772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Licenses✔ Licensed in UT · 340426-6004✔ Licensed in UT · 5170621-6004
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 6281940-3501 (UT)
Also ListedClinical Nurse Specialist · Psychiatric/Mental HealthTaxonomy 364SP0808X · License 210158-4405 (UT)
352 S DENVER ST STE 350, Slc, UT 84111
Open in Google Maps ↗

Other Identifiers 1

Other340426600001001UT · Bcbs Ut

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Charles L Diviney Iii Mc Lpc Ncc Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Charles L Diviney III Mc Lpc Ncc LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Andrea Rubido
Clinical Social Worker
NPI 1144847674
352 S DENVER ST STE 350
Salt Lake City, UT 84111
(801) 521-4227
✔ PECOSSame address
Zachery Shinkle
Mental Health Counselor
NPI 1649088550
117 W 400 S
Salt Lake City, UT 84101
(801) 428-4257
✔ PECOS1.4 mi
Raquel Cook
Mental Health Counselor
NPI 1255582102
660 S 200 E STE 308
Salt Lake City, UT 84111
(801) 355-1528
✔ PECOS5.6 mi
John Selin, C.S.W.
Clinical Social Worker
NPI 1184882722
237 26TH ST
Ogden, UT 84401
(801) 625-3700
✔ PECOS32 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles L Diviney III Mc Lpc Ncc LLC's NPI number?

The NPI number for Charles L Diviney III Mc Lpc Ncc LLC is 1235447772. It was assigned to this organization in the NPPES registry on September 17, 2010.

Where is Charles L Diviney III Mc Lpc Ncc LLC located?

Charles L Diviney III Mc Lpc Ncc LLC is located at 352 S Denver St Ste 350, Slc, UT 84111. The listed phone number is (801) 521-4227.

What is Charles L Diviney III Mc Lpc Ncc LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Charles L Diviney III Mc Lpc Ncc LLC enrolled in Medicare?

Yes. Charles L Diviney III Mc Lpc Ncc LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Charles L Diviney III Mc Lpc Ncc LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Charles L Diviney III Mc Lpc Ncc LLC, in Clinical Social Worker and Mental Health Counselor. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Charles L Diviney III Mc Lpc Ncc LLC accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Charles L Diviney III Mc Lpc Ncc LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Charles L Diviney III Mc Lpc Ncc LLC was last updated on October 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.