Individual provider Active NPI

Jaime Lee Houskeeper

  • Psychologist
  • Provo, UT
National Provider Identifier
1407159007
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
8091994-2501 Issued in UT
Practice address
750 N Freedom Blvd
Provo, UT 84601-1677
Phone
(801) 852-4760
NPI assigned
Dec 21, 2010
Last updated
May 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 8091994-2501 UT Primary

Addresses

Primary practice location

750 N Freedom Blvd
Provo, UT 84601-1677

Mailing address

13648 S 2860 W
Riverton, UT 84065-5925
Phone (801) 910-9485

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
I20130131000333 UT Practitioner - Clinical Psychologist 6608020540 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wasatch Behavioral Health Special Service District CurrentSince Dec 24, 2012 Accepting new patients
Wasatch Behavioral Health Special Service District CurrentSince Dec 24, 2012 Accepting new patients
Copper Valley Psychology, LLC CurrentSince Oct 1, 2023 Accepting new patients

Locations

11616 S State St
Ste 1505
Draper, UT 84020
Phone (801) 332-9370

11845 S 700 E
Ste 104
Draper, UT 84020
Phone (801) 332-9370

750 N Freedom Blvd
Provo, UT 84601
Phone (801) 373-0639

750 N Freedom Blvd
#205C
Provo, UT 84601

750 N Freedom Blvd
Ste 300
Provo, UT 84601
Phone (801) 372-4760

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1292889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1407159007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13648 S 2860 W",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840655925",
            "telephone_number": "801-910-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011677",
            "telephone_number": "801-852-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSKEEPER",
        "first_name": "JAIME",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-21",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "8091994-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.