Jennifer Allen Ericksen, CSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

13964016-3502 Issued in UT

Practice address

563 W 500 S Ste 440
Bountiful, UT 84010-8296

Phone

(385) 503-5646

NPI assigned

Aug 9, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1639900970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 N 2475 W",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417763",
            "telephone_number": "801-513-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "563 W 500 S STE 440",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108296",
            "telephone_number": "385-503-5646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1434 N 2475 W",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840417763",
            "country_code": "US",
            "telephone_number": "801-513-8875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICKSEN",
        "first_name": "JENNIFER",
        "middle_name": "ALLEN",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "13964016-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Bruce Empey, M.D.
• Christopher Steven English, M.D.
• Dayna Epperson, OTR/L
• Eric C. Johnston MD Inc.
• Alena Ericksen, CMHC
• Scott Erickson
• Kristin Erskine, LPC NCC
• Jessica Esau
• Tara L Eschler
• Edgar Escobedo

• 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 Aug 9, 2024; 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.