Individual provider Active NPI

Pamala Diane Roskelley-Johnson, LPC

  • Professional Counselor
  • Salt Lake City, UT
National Provider Identifier
1114006285
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
367557-6004 Issued in UT
Practice address
150 S 600 E
Suite 1C
Salt Lake City, UT 84102-1999
Phone
(801) 808-1616
Fax
(801) 486-1113
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 367557-6004 UT Primary

Addresses

Primary practice location

150 S 600 E
Suite 1C
Salt Lake City, UT 84102-1999

Mailing address

1116 Kensington Ave
Salt Lake City, UT 84105-2536
Phone (801) 808-1616

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

LicenseStateTypeSpecialty
367557-6004UTMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207267200000",
    "number": "1114006285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 KENSINGTON AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841052536",
            "telephone_number": "801-808-1616",
            "fax_number": "801-486-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S 600 E",
            "address_2": "SUITE 1C",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021999",
            "telephone_number": "801-808-1616",
            "fax_number": "801-486-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSKELLEY-JOHNSON",
        "first_name": "PAMALA",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "UT",
            "license": "367557-6004",
            "primary": true
        }
    ],
    "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 Apr 4, 2008; 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.