Active NPI
Jodi L Forsgren, LPC
- Mental Health Counselor
- Logan, UT
National Provider Identifier
1497845929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4979666-6004
- Practice address
- 90 E 200 N
Logan, UT 84321-4034 - Phone
- (435) 752-0750
- Fax
- (435) 752-7433
- NPI assigned
- Oct 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4979666-6004 | UT | Primary |
Addresses
Primary practice location
90 E 200 N
Logan, UT 84321-4034
Mailing address
25 West 200 North
Wellsville, UT 84339
Phone (435) 245-9530
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4979666-6004 | UT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497845929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 WEST 200 NORTH",
"city": "WELLSVILLE",
"state": "UT",
"postal_code": "84339",
"telephone_number": "435-245-9530",
"fax_number": "435-752-7433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 E 200 N",
"city": "LOGAN",
"state": "UT",
"postal_code": "843214034",
"telephone_number": "435-752-0750",
"fax_number": "435-752-7433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORSGREN",
"first_name": "JODI",
"middle_name": "L",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "UT",
"license": "4979666-6004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.