NPIMap

Organization Active NPI

Doug and Betty Ford Counseling LLC

  • Mental Health Counselor
  • Elk Ridge, UT
National Provider Identifier
1316339443
Registry record updated Feb 26, 2015
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Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3315546004 Issued in UT
Legal business name
DOUG AND BETTY FORD COUNSELING LLC
Practice address
216 Cougar Cir
Elk Ridge, UT 84651-9565
Phone
(801) 921-9495
NPI assigned
Feb 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2015

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

Authorized official

Name
Cheryl Ipson
Title
Billng Manager
Phone
(801) 921-9495

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 3315546004 UT Primary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X 49290043501 UT

Addresses

Primary practice location

216 Cougar Cir
Elk Ridge, UT 84651-9565

Mailing address

PO Box 222
Salem, UT 84653-0222
Phone (801) 921-9495

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424908800000",
    "number": "1316339443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 222",
            "city": "SALEM",
            "state": "UT",
            "postal_code": "846530222",
            "telephone_number": "801-921-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 COUGAR CIR",
            "city": "ELK RIDGE",
            "state": "UT",
            "postal_code": "846519565",
            "telephone_number": "801-921-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUG AND BETTY FORD COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-26",
        "last_updated": "2015-02-26",
        "status": "A",
        "authorized_official_last_name": "IPSON",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "BILLNG MANAGER",
        "authorized_official_telephone_number": "801-921-9495"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "3315546004",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "49290043501",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Ridge, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.