NPIMap

Organization Active NPI

Inclusive Minded Counseling & Consulting, LLC

  • Clinical Social Worker
  • South Salt Lake, UT
National Provider Identifier
1104643501
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
INCLUSIVE MINDED COUNSELING & CONSULTING, LLC
Practice address
3763 S Secord St
South Salt Lake, UT 84115-4771
Phone
(801) 210-1686
NPI assigned
Sep 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Authorized official

Name
Martha Lilia Soto Ceballos, LCSWNPI 1114558376
Title
Owner & Therapist
Phone
(801) 210-9159

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 2

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

Addresses

Primary practice location

3763 S Secord St
South Salt Lake, UT 84115-4771

Mailing address

5495 S 4015 W Unit 18156
Salt Lake City, UT 84118-9407

National Provider Directory

National Provider Directory

Locations

5495 S 4015 W
Unit 18156
Salt Lake City, UT 84118

Practitioners & affiliated clinicians

Practitioners 3

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": "1727222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1104643501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5495 S 4015 W UNIT 18156",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841189407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3763 S SECORD ST",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841154771",
            "telephone_number": "801-210-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INCLUSIVE MINDED COUNSELING & CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "SOTO CEBALLOS",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "LILIA",
        "authorized_official_title_or_position": "OWNER & THERAPIST",
        "authorized_official_telephone_number": "801-210-9159",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Salt Lake, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.