Active NPI
Farrah Dawn Petersen, CMHC
- Counselor
- Pleasant Grove, UT
National Provider Identifier
1508657388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 13591394-6004
- Practice address
- 2303 N 1420 W
Pleasant Grove, UT 84062-5029 - Phone
- (801) 400-4731
- NPI assigned
- May 13, 2025
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 13591394-6004 | UT | Primary |
Addresses
Primary practice location
2303 N 1420 W
Pleasant Grove, UT 84062-5029
Mailing address
2303 N 1420 W
Pleasant Grove, UT 84062-5029
Phone (801) 400-4731
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 |
|---|---|---|---|
| 13591394-6004 | UT | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747094400000",
"number": "1508657388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2303 N 1420 W",
"city": "PLEASANT GROVE",
"state": "UT",
"postal_code": "840625029",
"telephone_number": "801-400-4731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2303 N 1420 W",
"city": "PLEASANT GROVE",
"state": "UT",
"postal_code": "840625029",
"telephone_number": "801-400-4731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "FARRAH",
"middle_name": "DAWN",
"name_prefix": "Mrs.",
"credential": "CMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-05-13",
"last_updated": "2025-05-13",
"certification_date": "2025-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "UT",
"license": "13591394-6004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasant Grove, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.