Individual provider Active NPI

Jennifer Michelle Moleni, LCSW

  • Mental Health Counselor
  • Cottonwood Heights, UT
National Provider Identifier
1669770343
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
77532093503 Issued in UT
Practice address
2100 Bengal Blvd # H340
Cottonwood Heights, UT 84121-7135
Phone
(801) 263-7277
NPI assigned
Mar 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7753209-3501 UT
Mental Health Counselor 101YM0800X 77532093503 UT Primary

Addresses

Primary practice location

2100 Bengal Blvd # H340
Cottonwood Heights, UT 84121-7135

Mailing address

6069 W Haven Ridge Way
West Valley City, UT 84128-5639
Phone (815) 298-0425

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
77532093503UTMDMental Health Counselor
7753209-3501UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1299196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1669770343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6069 W HAVEN RIDGE WAY",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841285639",
            "telephone_number": "815-298-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 BENGAL BLVD # H340",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841217135",
            "telephone_number": "801-263-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLENI",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-04",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "7753209-3501",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "77532093503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood Heights, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.