Individual provider Active NPI

Theresa Rose Oconnor, P.P.C.

  • Professional Counselor
  • Murray, UT
National Provider Identifier
1629388202
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8634614-6009 Issued in UT
Practice address
925 E Executive Park Dr Ste B
Murray, UT 84117-3545
Phone
(801) 432-0857
Fax
(801) 880-2859
NPI assigned
Oct 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Case Manager/Care Coordinator 171M00000X 6681105 UT
Professional Counselor 101YP2500X C5932 OR
Professional Counselor 101YP2500X 8634614-6004 UT
Professional Counselor 101YP2500X 8634614-6009 UT Primary

Addresses

Primary practice location

925 E Executive Park Dr Ste B
Murray, UT 84117-3545

Mailing address

5446 W Kathleen Ave
West Valley City, UT 84120-2712
Phone (801) 859-9798

Other practice location 1

3556 S 5600 W # 421
Salt Lake City, UT 84120-2815
Phone (801) 432-0857

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260604003177 OR Practitioner - Mental Health Counselor 7719458348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roseburg Therapy LLCGroup PAC ID 6608109475, 16 clinicians

Practice addresses (Care Compare)

2460 NW Troost St
Suite 1
Roseburg, OR 97471-7704
Phone (541) 900-4285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C5932ORMDProfessional Counselor
8634614-6004UTMDProfessional Counselor
8634614-6009UTMDProfessional Counselor
6681105UTMDCase Manager/Care Coordinator

Interoperability endpoints

  • Direct secure messaging: toconnor296478@direct.ochin.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1629388202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5446 W KATHLEEN AVE",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841202712",
            "telephone_number": "801-859-9798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 E EXECUTIVE PARK DR STE B",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841173545",
            "telephone_number": "801-432-0857",
            "fax_number": "801-880-2859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3556 S 5600 W # 421",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841202815",
            "country_code": "US",
            "telephone_number": "801-432-0857",
            "fax_number": "801-880-2859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OCONNOR",
        "first_name": "THERESA",
        "middle_name": "ROSE",
        "credential": "P.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-15",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "UT",
            "license": "6681105",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C5932",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "UT",
            "license": "8634614-6004",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "UT",
            "license": "8634614-6009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.