Organization Active NPI

Live Well Counseling Services PLLC

  • Clinical Social Worker
  • South Jordan, UT
National Provider Identifier
1366079097
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
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

Updated by the provider on Aug 16, 2024

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)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

Locations

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.

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.

Verify at the official NPI Registry.