CAMILLE DELONG B.S. M.S. LMFT
NPI 1629325097
Marriage & Family Therapist in Salt Lake City, UT

Q: What is the provider's specialty?

The provider's specialty is Marriage & Family Therapist with taxonomy code 106H00000X.

Active since August 05, 2012PECOS Enrolled

275 E SOUTH TEMPLE, SUITE 101, SALT LAKE CITY, UT 84111(180) 153-1738 Get Directions Write a Review

NPPES record last updated: August 5, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Camille Delong B.s. M.s. Lmft NPPES

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

CAMILLE DELONG B.S. M.S. LMFT (NPI 1629325097) is an individual marriage & family therapist in Salt Lake City, Utah, licensed in Utah (1142433902) and active in the NPI registry since August 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629325097

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameCAMILLE DELONGCredential: B.S. M.S. LMFT

Location Address275 E SOUTH TEMPLE, SUITE 101Salt Lake City, UT 84111-1247

Mailing Address812 Sandhurst DrSalt Lake City, UT 84103-2284 · (180) 131-7904 · Fax (180) 136-4368

Phone(180) 153-1738

Sole ProprietorYes

Enumeration DateAugust 5, 2012

✔ NPI 1629325097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in UT · 1142433902

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

275 E SOUTH TEMPLE, Salt Lake City, UT 84111

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Camille Delong B.s. M.s. Lmft has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 20, 2024 through February 20, 2026.

Opt-Out Effective DateFebruary 20, 2024

Opt-Out In Effect ThroughFebruary 20, 2026Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.