Caroline Kellough

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10371472-6004 Issued in UT

Practice address

4465 S 900 E Ste 150
Millcreek, UT 84124-3944

Phone

(435) 248-2089

NPI assigned

Nov 18, 2019

Last updated

Nov 18, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

• Healing Pathways Therapy Center

  • Mental Health Counselor
  • Salt Lake City, UT
  • NPI 1437580495
  NPD (past)

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1578108205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4465 S 900 E STE 150",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841243944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 S 900 E STE 150",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841243944",
            "telephone_number": "435-248-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOUGH",
        "first_name": "CAROLINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "10371472-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.therapypartner.com/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4465 S 900 E Ste 150",
            "city": "Millcreek",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841243944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shaley Jarvis
• Kayla Jessop, RDN, CDN, CEDS-S
• Carly Jones, LMT
• Journey Mental Health
• Jeffrey David Kay
• Kelly Winslow LCSW, LLC
• Kindly MD, Inc.
• Larry Andrew Kinnett
• Roberto Lara
• Laracounseling (HeartMind)

• Mental Health Counselor in Millcreek, UT
• Providers in Millcreek, 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 Nov 18, 2019; 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.