Active NPI
Live Well Counseling Services PLLC
- Clinical Social Worker
- South Jordan, UT
National Provider Identifier
1366079097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- LIVE WELL COUNSELING SERVICES PLLC
- Practice address
- 11748 S 3600 W Ste 3
South Jordan, UT 84095-5922 - Phone
- (801) 896-8133
- NPI assigned
- Mar 24, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jacob K Vickrey
- Title
- Owner
- Phone
- (801) 896-8133
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
11748 S 3600 W Ste 3
South Jordan, UT 84095-5922
Mailing address
11748 S 3600 W Ste 3
South Jordan, UT 84095-5922
Phone (801) 896-8133
National Provider Directory
National Provider DirectoryLocations
3654 W 9800 S
South Jordan, UT 84009
Phone (801) 896-8133
11748 S 3600 W
Ste 3
South Jordan, UT 84095
Phone (801) 896-8133
10654 S River Heights Dr
Ste 320
South Jordan, UT 84095
Phone (760) 792-3671
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Mental Health Counselor
- Provo, UT
- NPI 1841834975
-
- Social Worker
- South Jordan, UT
- NPI 1053148767
-
- Clinical Social Worker
- Orem, UT
- NPI 1073110805
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585008000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1723766400000",
"number": "1366079097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11748 S 3600 W STE 3",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840955922",
"telephone_number": "801-896-8133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11748 S 3600 W STE 3",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840955922",
"telephone_number": "801-896-8133"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIVE WELL COUNSELING SERVICES PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-03-24",
"last_updated": "2024-08-16",
"certification_date": "2024-08-16",
"status": "A",
"authorized_official_last_name": "VICKREY",
"authorized_official_first_name": "JACOB",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "801-896-8133"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.