Individual provider Active NPI

Jennifer Roach, MA, LCMHC

  • Mental Health Counselor
  • Springville, UT
National Provider Identifier
1003247677
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1076 W 1275 S
Springville, UT 84663-5060
Phone
(206) 427-7754
Fax
(425) 258-5275
NPI assigned
Dec 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCPC-8331 ID
Mental Health Counselor 101YM0800X Primary
Mental Health Counselor 101YM0800X LH61155476 WA
Mental Health Counselor 101YM0800X 12888612-6004 UT

Addresses

Primary practice location

1076 W 1275 S
Springville, UT 84663-5060

Mailing address

1076 W 1275 S
Springville, UT 84663-5060
Phone (206) 427-7754

Other identifiers 1

IdentifierTypeStateIssuer
2064277754OtherCONTACT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240609000192 UT Practitioner - Mental Health Counselor 5294277026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeworkman IncGroup PAC ID 9931566288, 2 clinicians

Practice addresses (Care Compare)

3585 N University Ave
Walker Building Suite 300
Provo, UT 84604-6601
Phone (801) 797-1111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LCPC-8331IDMDMental Health Counselor
12888612-6004UTMDMental Health Counselor
LH61155476WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Aeworkman, Inc Mental Health CurrentSince Mar 25, 2024 Accepting new patients
Quell Counseling Mental Health CurrentSince May 31, 2026 Accepting new patients
Catholic Community Services Western Washington Past Accepting new patients

Locations

3585 N University Ave
Ste 300
Provo, UT 84604
Phone (801) 797-1111

3585 N University Ave
Bldg Sui
Provo, UT 84604
Phone (801) 797-1111

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1003247677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 W 1275 S",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846635060",
            "telephone_number": "206-427-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 W 1275 S",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846635060",
            "telephone_number": "206-427-7754",
            "fax_number": "425-258-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "JENNIFER",
        "credential": "MA, LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-09",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-8331",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61155476",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "12888612-6004",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTACT",
            "identifier": "2064277754",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springville, UT

Sources for this page

Verify at the official NPI Registry.