Individual provider Active NPI

Elyse Roberts, CMHC

  • Mental Health Counselor
  • South Salt Lake, UT
National Provider Identifier
1184925828
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8001374-6004 Issued in UT
Practice address
177 W Price Ave
South Salt Lake, UT 84115-4345
Phone
(854) 684-4773
NPI assigned
Nov 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X 8001374-6004 UT Primary

Addresses

Primary practice location

177 W Price Ave
South Salt Lake, UT 84115-4345

Mailing address

177 W Price Ave
South Salt Lake, UT 84115-4345
Phone (385) 468-4477

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
8001374-6004UTMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1184925828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 W PRICE AVE",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841154345",
            "telephone_number": "385-468-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 W PRICE AVE",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841154345",
            "telephone_number": "854-684-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ELYSE",
        "credential": "CMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-11",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "8001374-6004",
            "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 Dec 15, 2023; 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.