Terra Prince, ACMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

11501401-6009 Issued in UT

Practice address

10808 S River Front Pkwy Ste 308
South Jordan, UT 84095-5761

Phone

(801) 984-6726

Fax

(801) 984-4715

NPI assigned

Oct 30, 2019

Last updated

Oct 30, 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

Other identifiers 1

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

Locations

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.

• Blue Theory Counseling LLC

  • Mental Health Counselor
  • South Jordan, UT
  • NPI 1992403513
  NPD

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1609410810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10808 S RIVER FRONT PKWY STE 308",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955761",
            "telephone_number": "801-984-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10808 S RIVER FRONT PKWY STE 308",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955761",
            "telephone_number": "801-984-6726",
            "fax_number": "801-984-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "TERRA",
        "credential": "ACMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "11501401-6009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOPL",
            "identifier": "11501401-6009",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tprince@counselingmail.com",
            "affiliation": "N",
            "endpointDescription": "Provider Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct email messaging",
            "address_1": "10808 S River Front Pkwy Ste 308",
            "city": "South Jordan",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840955761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Premier Medical Distribution
• Joshua Presley, DDS
• Christopher Joseph Price, DDS, MD
• Primary Function, PLLC
• Prime Labs LLC
• Pro Smiles Utah LLC
• Tyler Proctor, DC
• Progressive Eye Care, LLC
• Promise Hospital
• Psychological Assessment & Intervention Resources, PC

• Mental Health Counselor in South Jordan, UT
• Providers in South Jordan, 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 Oct 30, 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.