Jennifer Poulos, LCSW, LSUDC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8139526-3501 Issued in UT

Practice address

1412 S Legend Hills Dr Ste 334
Clearfield, UT 84015-1592

Phone

(801) 608-9966

NPI assigned

Feb 25, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Valley Behavioral Health Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Valley City, UT
  • NPI 1932166980
  Medicare reassignment
• Valley Mental Health Incorporated

  • Psychiatry Physician
  • Salt Lake City, UT
  • NPI 1275599797

  Addiction (Substance Use Disorder)

  NPD

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

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1407153547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 E 2600 S",
            "city": "CLEARFIELD",
            "state": "UT",
            "postal_code": "840151951",
            "telephone_number": "801-608-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 S LEGEND HILLS DR STE 334",
            "city": "CLEARFIELD",
            "state": "UT",
            "postal_code": "840151592",
            "telephone_number": "801-608-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULOS",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "LCSW, LSUDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-25",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "8139526-3501",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "8139526-6006",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "8139526-3506",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siena Podgorny, OT
• Kendra Noel Poorman, LMT
• Jennie Lynne Porter, N.D.
• Melinda Porter
• Heather D Potokar, LCSW
• Premier Health Care Services, L.C.
• Psych Matter PLLC
• Pure Life Counseling, LLC
• Pure Sky
• Rallison Dental LLC

• Clinical Social Worker in Clearfield, UT
• Providers in Clearfield, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.