MICHELLE M WICKERSHAM CMHC
NPI 1275007338
Counselor - Mental Health in Layton, UT

Q: What is Michelle Wickersham's NPI number?

The NPI number for Michelle Wickersham is 1275007338. It was assigned to this individual provider in the NPPES registry on January 11, 2019. The provider is also known as Micky M Wickersham Cmhc.

Q: What is Michelle Wickersham's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Active since January 11, 2019PECOS Enrolled

476 HERITAGE PARK BLVD STE 220, LAYTON, UT 84041(801) 554-0006(801) 899-7793 Get Directions Write a Review

NPPES record last updated: July 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 11, 2025, Aug 2, 2024, Jan 11, 2019 (3 updates tracked since 2019).

On this page

About Michelle M Wickersham Cmhc NPPES

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

MICHELLE M WICKERSHAM CMHC (NPI 1275007338) is an individual mental health provider in Layton, Utah, licensed in Utah (9012474-6004) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Millcreek.

NPPES Registry Identity

NPI1275007338

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameMICHELLE M WICKERSHAMCredential: CMHC

Location Address476 HERITAGE PARK BLVD STE 220Layton, UT 84041-5679

Mailing Address1084 Weaver LnLayton, UT 84041-3514 · (801) 554-0006 · Fax (801) 899-7793

Phone(801) 554-0006

Fax(801) 899-7793

Sole ProprietorNo

Enumeration DateJanuary 11, 2019

Last NPPES UpdateJuly 11, 20253 updates tracked since enumeration

NPPES CertifiedJuly 11, 2025

✔ NPI 1275007338 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in UT · 9012474-6004

476 HERITAGE PARK BLVD STE 220, Layton, UT 84041

Open in Google Maps ↗

Other Names 1

Other Name (5)Micky M Wickersham Cmhc

Secondary Practice Location 1

Location 14455 S 700 E Ste 300Millcreek, UT 84107-3076 · Phone (801) 899-9492 · Fax (801) 899-7793

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michelle M Wickersham Cmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KORTNEY LYNNE JENSEN

Social Worker (Clinical)