Individual provider Active NPI

Jessica Peterson, ACMHC, LMHCA

  • Mental Health Counselor
  • Orem, UT
National Provider Identifier
1043123391
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
14311038-6009 Issued in UT
Practice address
1422 E 820 N
Orem, UT 84097-5481
Phone
(385) 309-1038
NPI assigned
Sep 28, 2026
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MHCA.MC.70181646 WA
Mental Health Counselor 101YM0800X 14311038-6009 UT Primary

Addresses

Primary practice location

1422 E 820 N
Orem, UT 84097-5481

Mailing address

11 Two Rivers Rd
Mazama, WA 98833-9723

Other practice location 1

315 Riverside Ave Ste 207
Winthrop, WA 98862-0017
Phone (503) 894-4980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1043123391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 TWO RIVERS RD",
            "city": "MAZAMA",
            "state": "WA",
            "postal_code": "988339723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 E 820 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840975481",
            "telephone_number": "385-309-1038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 Riverside Ave Ste 207",
            "address_purpose": "LOCATION",
            "city": "Winthrop",
            "state": "WA",
            "postal_code": "988620017",
            "country_code": "US",
            "telephone_number": "503-894-4980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JESSICA",
        "credential": "ACMHC, LMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-28",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MHCA.MC.70181646",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "14311038-6009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.