NPIMap

Organization Active NPI

Life Choices Counseling & Services, Inc.

  • Clinical Social Worker
  • Bountiful, UT
National Provider Identifier
1265546758
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
112679-3501 Issued in UT
Legal business name
LIFE CHOICES COUNSELING & SERVICES, INC.
Practice address
406 N Main St
Bountiful, UT 84010-6035
Phone
(801) 755-2122
Fax
(801) 292-0268
NPI assigned
Aug 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Sydney R Jeffries, LCSWNPI 1609812940
Title
Owner/Therapist
Phone
(801) 755-2122

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 112679-3501 UT Primary

Addresses

Primary practice location

406 N Main St
Bountiful, UT 84010-6035

Mailing address

406 N Main St
Bountiful, UT 84010-6035
Phone (801) 755-2122

Other identifiers 1

IdentifierTypeStateIssuer
11267935000001OtherUTBCBS OF UTAH

National Provider Directory

National Provider Directory

Locations

406 N Main St
Bountiful, UT 84010
Phone (801) 755-2122

Practitioners & affiliated clinicians

Practitioners 2

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": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265546758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 N MAIN ST",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106035",
            "telephone_number": "801-755-2122",
            "fax_number": "801-292-0268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 N MAIN ST",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106035",
            "telephone_number": "801-755-2122",
            "fax_number": "801-292-0268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHOICES COUNSELING & SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JEFFRIES",
        "authorized_official_first_name": "SYDNEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "801-755-2122",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "112679-3501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF UTAH",
            "identifier": "11267935000001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.