Active NPI
Claire Delise, CMHC
- Mental Health Counselor
- South Jordan, UT
National Provider Identifier
1568008258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 11077067-6004
- Practice address
- 11260 S River Heights Dr
South Jordan, UT 84095-5119 - Phone
- (385) 308-8403
- NPI assigned
- Nov 18, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 11077067-6004 | UT | Primary |
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | 11077067-6009 | UT |
Addresses
Primary practice location
11260 S River Heights Dr
South Jordan, UT 84095-5119
Mailing address
11260 S River Heights Dr
South Jordan, UT 84095-5119
Phone (385) 308-8403
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 |
|---|---|---|---|
| 11077067-6004 | UT | MD | Mental Health Counselor |
| 11077067-6009 | UT | MD | Emotionally Disturbed Childrens' Residential Treatment Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704931200000",
"number": "1568008258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11260 S RIVER HEIGHTS DR",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840955119",
"telephone_number": "385-308-8403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11260 S RIVER HEIGHTS DR",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840955119",
"telephone_number": "385-308-8403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELISE",
"first_name": "CLAIRE",
"name_prefix": "Ms.",
"credential": "CMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-18",
"last_updated": "2024-01-11",
"certification_date": "2024-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "UT",
"license": "11077067-6004",
"primary": true
},
{
"code": "322D00000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Emotionally Disturbed Children",
"state": "UT",
"license": "11077067-6009",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.