Individual provider Active NPI

Lisa Lyn Jones, PH.D.

  • Counseling Psychologist
  • Salt Lake City, UT
National Provider Identifier
1285700658
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
5312699-2501 Issued in UT
Practice address
4190 S Highland Dr Ste 210
Salt Lake City, UT 84124-2674
Phone
(385) 399-3696
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 5312699-2501 UT Primary

Addresses

Primary practice location

4190 S Highland Dr Ste 210
Salt Lake City, UT 84124-2674

Mailing address

1612 E Gregson Ave
Salt Lake City, UT 84106-3422
Phone (385) 399-3696

Other practice location 1

1433 N 1075 W Ste 120
Farmington, UT 84025-2746
Phone (385) 399-3696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190305002782 UT Practitioner - Clinical Psychologist 0446599690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
5312699-2501UTMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1285700658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 E GREGSON AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063422",
            "telephone_number": "385-399-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 S HIGHLAND DR STE 210",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242674",
            "telephone_number": "385-399-3696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1433 N 1075 W Ste 120",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "UT",
            "postal_code": "840252746",
            "country_code": "US",
            "telephone_number": "385-399-3696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "LISA",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "UT",
            "license": "5312699-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.