Individual provider Active NPI

Jessica Shaw Andersen, LPC

  • Mental Health Counselor
  • Lehi, UT
National Provider Identifier
1639441058
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6235427-6004 Issued in UT
Practice address
210 N 1200 E
Suite 205
Lehi, UT 84043-2297
Phone
(801) 822-2699
NPI assigned
Jan 31, 2012
Last updated
Jan 31, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6235427-6004 UT Primary

Addresses

Primary practice location

210 N 1200 E
Suite 205
Lehi, UT 84043-2297

Mailing address

246 S 175 E
Orem, UT 84058-5566
Phone (801) 822-2699

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

LicenseStateTypeSpecialty
6235427-6004UTMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1327968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1639441058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 S 175 E",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840585566",
            "telephone_number": "801-822-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N 1200 E",
            "address_2": "SUITE 205",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840432297",
            "telephone_number": "801-822-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "JESSICA",
        "middle_name": "SHAW",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-31",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "6235427-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehi, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2012; 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.