Individual provider Active NPI

Trenton Joe Landon, PHD, CRC

  • Mental Health Counselor
  • Logan, UT
National Provider Identifier
1255030912
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11373560-6009 Issued in UT
Practice address
6405 Old Main Hill
Logan, UT 84322-0001
Phone
(435) 797-3269
NPI assigned
Mar 1, 2023
Last updated
Mar 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 11373560-6009 UT Primary

Addresses

Primary practice location

6405 Old Main Hill
Logan, UT 84322-0001

Mailing address

612 N 750 E
Hyde Park, UT 84318-3366
Phone (517) 281-8758

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
11373560-6009UTMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1255030912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 N 750 E",
            "city": "HYDE PARK",
            "state": "UT",
            "postal_code": "843183366",
            "telephone_number": "517-281-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 OLD MAIN HILL",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843220001",
            "telephone_number": "435-797-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDON",
        "first_name": "TRENTON",
        "middle_name": "JOE",
        "name_prefix": "Dr.",
        "credential": "PHD, CRC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "11373560-6009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.