Johnathon Dahlin Peterson, LCMHC, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

11125479-6004 Issued in UT

Practice address

1268 W South Jordan Pkwy Ste 300
South Jordan, UT 84095-4653

Phone

(801) 515-5850

Fax

(801) 254-9755

NPI assigned

Aug 4, 2022

Last updated

Sep 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• FFP Mental Health LLC

  dba Families First Counseling

  • Clinical Social Worker
  • South Jordan, UT
  • NPI 1326778911

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1487381869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95868",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840950868",
            "telephone_number": "801-515-5850",
            "fax_number": "801-254-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 W SOUTH JORDAN PKWY STE 300",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954653",
            "telephone_number": "801-515-5850",
            "fax_number": "801-254-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JOHNATHON",
        "middle_name": "DAHLIN",
        "credential": "LCMHC, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-04",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "95059",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "11125479-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "advancedmd.com",
            "affiliation": "Y",
            "endpointDescription": "AdvancedMD",
            "affiliationName": "FFP MENTAL HEALTH LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "698 W 10000 S",
            "city": "South Jordan",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840954031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Charli Danielle Peters, A.P.R. N
• Petersen Dental LLC
• Sarah Connors Petersen, MD
• Brad Niel Peterson, D.C.
• Catherine Peterson
• Matthew Wade Peterson, D.C.
• Mitchell Alan Peterson, MD
• Valerie Peterson
• Zoe Pettersson
• Devrie Pettit, MS, RDN

• Mental Health Counselor in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.