Individual provider Active NPI

David W Jensen, LPC

  • Community/Behavioral Health Agency
  • West Jordan, UT
National Provider Identifier
1417225012
Registry record updated Dec 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
5714096-6004 Issued in UT
Practice address
6436 S 5180 W
West Jordan, UT 84081-3812
Phone
(801) 916-0701
NPI assigned
Dec 9, 2011
Last updated
Dec 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 5714096-6004 UT Primary

Addresses

Primary practice location

6436 S 5180 W
West Jordan, UT 84081-3812

Mailing address

6436 S 5180 W
West Jordan, UT 84081-3812
Phone (801) 916-0701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5714096-6004UTMDCommunity/Behavioral Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323388800000",
    "number": "1417225012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6436 S 5180 W",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840813812",
            "telephone_number": "801-916-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6436 S 5180 W",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840813812",
            "telephone_number": "801-916-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "DAVID",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-09",
        "last_updated": "2011-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "UT",
            "license": "5714096-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; 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.