Sydney R Jeffries, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

112679-3501 Issued in UT

Practice address

406 N Main St
Bountiful, UT 84010-6035

Phone

(801) 755-2122

Fax

(801) 292-0268

NPI assigned

Jun 22, 2006

Sex

Male

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

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.

• Life Choices Counseling & Services, Inc.

  • Clinical Social Worker
  • Bountiful, UT
  • NPI 1265546758
  NPD (past) Authorized official
• Futures Through Choices, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • West Haven, UT
  • NPI 1902956055
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609812940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 N MAIN ST",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106035",
            "telephone_number": "801-755-2122",
            "fax_number": "801-292-0268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 N MAIN ST",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106035",
            "telephone_number": "801-755-2122",
            "fax_number": "801-292-0268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFRIES",
        "first_name": "SYDNEY",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "112679-3501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "11267935000001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Launee Lyn Janes, COTA
• Jared J Tyson MD PC
• Carmela J Javellana, MD
• Garrett Tanner Jefferies
• Jeffery R. Oka, M.D., P.C.
• Mardiene Jeffs, PA-C
• Erik Jenkins, LCSW
• Kristopher B Jenkins, FNP-C
• Elva Michelle Jensen
• Jill Jensen, CSW

• Mental Health Counselor in Bountiful, UT
• Providers in Bountiful, 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 Jul 8, 2007; 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.