Individual provider Active NPI

Julie Jeanette Chan Boon, LCSW

  • Mental Health Counselor
  • West Jordan, UT
National Provider Identifier
1700156437
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11008471-3501 Issued in UT
Practice address
8783 S Redwood Rd Ste B
West Jordan, UT 84088-5640
Phone
(385) 276-7825
Fax
(385) 360-1698
NPI assigned
Jan 11, 2012
Last updated
Sep 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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 11008471-3501 UT Primary

Addresses

Primary practice location

8783 S Redwood Rd Ste B
West Jordan, UT 84088-5640

Mailing address

8783 S Redwood Rd Ste B
West Jordan, UT 84088-5640
Phone (385) 276-7825

Other practice location 1

1206 W South Jordan Pkwy Ste D
South Jordan, UT 84095-5519
Phone (801) 302-3801

Other names 1

  • Julie Jeanette King Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190717001370 UT Practitioner - Clinical Social Worker 8123307147 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Point Counseling Services, LLC Clinical CurrentSince Jun 10, 2019 Accepting new patients
First Choice Counseling and Consulting Services Mental Health CurrentSince Oct 2, 2022 Accepting new patients

Locations

1206 W South Jordan Pkwy
Ste D
South Jordan, UT 84095
Phone (801) 302-3801

8783 S Redwood Rd
Ste B
West Jordan, UT 84088
Phone (385) 276-7825

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1700156437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8783 S REDWOOD RD STE B",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840885640",
            "telephone_number": "385-276-7825",
            "fax_number": "385-360-1698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8783 S REDWOOD RD STE B",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840885640",
            "telephone_number": "385-276-7825",
            "fax_number": "385-360-1698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1206 W South Jordan Pkwy Ste D",
            "address_purpose": "LOCATION",
            "city": "South Jordan",
            "state": "UT",
            "postal_code": "840955519",
            "country_code": "US",
            "telephone_number": "801-302-3801",
            "fax_number": "801-302-3801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN BOON",
        "first_name": "JULIE",
        "middle_name": "JEANETTE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-11",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "11008471-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "KING",
            "middle_name": "JEANETTE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.