Active NPI
London Bertoch
- Mental Health Counselor
- West Jordan, UT
National Provider Identifier
1033767629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 11413713-6009
- Practice address
- 1561 W 7000 S Ste 200
West Jordan, UT 84084-3556 - Phone
- (801) 990-4300
- NPI assigned
- Aug 28, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 11413713-6009 | UT | Primary |
Addresses
Primary practice location
1561 W 7000 S Ste 200
West Jordan, UT 84084-3556
Mailing address
2096 W. Commanche Rd.
Farmington, UT 84025
Phone (928) 830-7133
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11413713-6009 | UT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566950400000",
"number": "1033767629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2096 W. COMMANCHE RD.",
"city": "FARMINGTON",
"state": "UT",
"postal_code": "84025",
"telephone_number": "928-830-7133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1561 W 7000 S STE 200",
"city": "WEST JORDAN",
"state": "UT",
"postal_code": "840843556",
"telephone_number": "801-990-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTOCH",
"first_name": "LONDON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-28",
"last_updated": "2019-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "UT",
"license": "11413713-6009",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.