Paul Jackman, MA, AMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10100228-3904 Issued in UT

Practice address

2994 S Gould Wash Rd
Hurricane, UT 84737

Phone

(435) 635-0636

NPI assigned

Oct 27, 2017

Last updated

Oct 27, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Paul Jackman Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1509062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509062400000",
    "number": "1093227209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E 2700 S",
            "city": "HURRICANE",
            "state": "UT",
            "postal_code": "847374000",
            "telephone_number": "435-669-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2994 S GOULD WASH RD",
            "city": "HURRICANE",
            "state": "UT",
            "postal_code": "84737",
            "telephone_number": "435-635-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKMAN",
        "first_name": "PAUL",
        "credential": "MA, AMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-27",
        "last_updated": "2017-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "10100228-3904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAUL",
            "last_name": "JACKMAN",
            "prefix": "MR.",
            "credential": "MA, AMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Samuel Isaac Inouye, MD
• Intermountain
• Robert Ipp, RN
• Desiree Irvine, DEM
• Courtney J Ivory, DPT
• Taylor Jacobson
• Susan Diana Jaeger, LPC
• Kevin D. Jenkins, D.C.
• Amanda Melanie Jocelyn, APRN-BC
• Joel C. Horne & Co., Inc. (Oasis Senior Living #3)

• Mental Health Counselor in Hurricane, UT
• Providers in Hurricane, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2017; 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.