NPIMap

Organization Active NPI

Penelope Bergeron Counseling

  • Clinical Social Worker
  • Spanish Fork, UT
National Provider Identifier
1275110769
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PENELOPE BERGERON COUNSELING
Practice address
212 S Main St Ste 201
Spanish Fork, UT 84660-5738
Phone
(385) 202-4089
Fax
(801) 877-9216
NPI assigned
Mar 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Authorized official

Name
Penelope Lynn Bergeron, LCSWNPI 1457719924
Title
Owner
Phone
(801) 318-7037

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: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

212 S Main St Ste 201
Spanish Fork, UT 84660-5738

Mailing address

5702 W 10770 N
Highland, UT 84003-9087
Phone (801) 318-7037

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL SpanishFork Direct

National Provider Directory

National Provider Directory

Locations

24 W Main St
Ste 223
Lehi, UT 84043

1384 W State Rd
Pleasant Grove, UT 84062
Phone (385) 202-4089

1570 S 1100 E
Salt Lake City, UT 84105
Phone (385) 202-4089

212 S Main St
Ste 201
Spanish Fork, UT 84660
Phone (385) 202-4089

212 S Main St
Spanish Fork, UT 84660
Phone (253) 209-8916

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1275110769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5702 W 10770 N",
            "city": "HIGHLAND",
            "state": "UT",
            "postal_code": "840039087",
            "telephone_number": "801-318-7037",
            "fax_number": "801-877-9216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S MAIN ST STE 201",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846605738",
            "telephone_number": "385-202-4089",
            "fax_number": "801-877-9216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENELOPE BERGERON COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "BERGERON",
        "authorized_official_first_name": "PENELOPE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-318-7037",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SpanishFork",
            "affiliation": "N",
            "endpointDescription": "mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "212 S Main St Ste 201",
            "city": "Spanish Fork",
            "state": "UT",
            "country_code": "US",
            "postal_code": "846605738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spanish Fork, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.