NPIMap

Organization Active NPI

Judicial Supervision Services, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Murray, UT
National Provider Identifier
1487294252
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
JUDICIAL SUPERVISION SERVICES, LLC
Practice address
5047 S Galleria Dr
Murray, UT 84123-4695
Phone
(801) 486-8143
Fax
(801) 746-6090
NPI assigned
Jan 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Authorized official

Name
Karena Z JacksonNPI 1821616368
Title
Program Director
Phone
(801) 486-8143

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Case Management Agency 251B00000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

5047 S Galleria Dr
Murray, UT 84123-4695

Mailing address

5047 S Galleria Dr
Murray, UT 84123-4695
Phone (801) 486-8143

Other practice location 1

370 S 500 E Ste 130
Clearfield, UT 84015-4001
Phone (801) 525-3009 ext. 1

Other practice location 2

1411 N State St Ste 4
Orem, UT 84057-2584
Phone (801) 746-6091 ext. 1

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address staff@judicialsupervision.com Direct

National Provider Directory

National Provider Directory

Locations

370 S 500 E
Ste 130
Clearfield, UT 84015
Phone 8015253009 ext. 1

1411 N State St
Ste 4
Orem, UT 84057
Phone 8017466091 ext. 1

5047 S Galleria Dr
Salt Lake City, UT 84123
Phone 8014868143 ext. 1

Practitioners & affiliated clinicians

Practitioners 9

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": "1578528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578528000000",
    "number": "1487294252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5047 S GALLERIA DR",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841234695",
            "telephone_number": "801-486-8143",
            "fax_number": "801-746-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5047 S GALLERIA DR",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841234695",
            "telephone_number": "801-486-8143",
            "fax_number": "801-746-6090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "370 S 500 E Ste 130",
            "address_purpose": "LOCATION",
            "city": "Clearfield",
            "state": "UT",
            "postal_code": "840154001",
            "country_code": "US",
            "telephone_number": "801-525-3009 x1",
            "fax_number": "801-746-6090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1411 N State St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Orem",
            "state": "UT",
            "postal_code": "840572584",
            "country_code": "US",
            "telephone_number": "801-746-6091 x1",
            "fax_number": "801-746-6090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JUDICIAL SUPERVISION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-09",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KARENA",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "801-486-8143"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "staff@judicialsupervision.com",
            "affiliation": "N",
            "endpointDescription": "staff@judicialsupervision.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "html",
            "address_1": "5047 S Galleria Dr",
            "city": "Murray",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841234695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; 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.