NPIMap

Organization Active NPI

Midtown Counseling

  • Professional Counselor
  • Salt Lake City, UT
National Provider Identifier
1033684618
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MIDTOWN COUNSELING
Practice address
4190 S Highland Dr Ste 210
Salt Lake City, UT 84124-2674
Phone
(801) 792-7028
NPI assigned
Oct 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Authorized official

Name
Dr. Kenneth David Roach, LCMHCNPI 1619189628
Title
Owner
Phone
(801) 860-7818

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

4190 S Highland Dr Ste 210
Salt Lake City, UT 84124-2674

Mailing address

1131 E Loch Lomond Way
Salt Lake City, UT 84117-4974
Phone (801) 860-7818

Other practice location 1

451 E 1000 S Ste B
Pleasant Grove, UT 84062-3735
Phone (801) 792-7028

National Provider Directory

National Provider Directory

Locations

4190 S Highland Dr
Ste 210
Salt Lake Cty, UT 84124
Phone (801) 278-8492

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539129600000",
    "number": "1033684618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 E LOCH LOMOND WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174974",
            "telephone_number": "801-860-7818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 S HIGHLAND DR STE 210",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242674",
            "telephone_number": "801-792-7028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "451 E 1000 S Ste B",
            "address_purpose": "LOCATION",
            "city": "Pleasant Grove",
            "state": "UT",
            "postal_code": "840623735",
            "country_code": "US",
            "telephone_number": "801-792-7028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDTOWN COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-10",
        "last_updated": "2018-10-10",
        "status": "A",
        "authorized_official_last_name": "ROACH",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-860-7818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.