Jennifer Carlson, CMCH MAC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

8336873-6004 Issued in UT

Practice address

8375 South 700East
Sandy, UT 84070

Phone

(801) 576-0745

NPI assigned

Mar 16, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Turning Point Centers

  • Substance Abuse Rehabilitation Facility
  • Sandy, UT
  • NPI 1306386669
  NPD (past)
• Utah Behavioral Health Services, LLC

  • Substance Abuse Rehabilitation Facility
  • Sandy, UT
  • NPI 1790569531

  Community Based Residential Treatment Facility, Mental Illness

  NPD (past)

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1508307083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8375 S 700 E",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840700504",
            "telephone_number": "801-576-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8375 SOUTH 700EAST",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "84070",
            "telephone_number": "801-576-0745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "JENNIFER",
        "credential": "CMCH MAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-16",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "UT",
            "license": "8336873-6004",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "UT",
            "license": "8336873-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Berret Capps
• Capstone Clinical Services
• Cara Drury Consulting LLC
• Care Treatment and Recreation
• Shaleena Carlisle, MSWI
• Keriann Carlson, RN
• Jeffrey Carr, LCSW
• Korbin Carr, OTR/L
• Benipcia Carrera, DDS
• Carrie a Chandler Aprn PLLC

• Substance Abuse Rehabilitation Facility in Sandy, UT
• Providers in Sandy, UT by specialty
• Substance Abuse Rehabilitation Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.